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NPI Code Detail

MEDICARE: MEDICAL NANNY

MEDICARE: MEDICAL NANNY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency
2374U00000XHome Health Aide
3376K00000XNurse's Aide
4163WH0200XHome Health Registered Nurse

General Provider Information

NPI Number : 1396417051
Entity Type Code : Organization
Provider Name (Legal Business Name) : MEDICAL NANNY
Provider Business Mailing Address
First Line : 1421 LEXINGTON AVE # 268
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-2629
Country : US
Telephone Number : 419-560-1168
Fax Number :
Provider Business Practice Location Address
First Line : 1421 LEXINGTON AVE # 268
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-2629
Country : US
Telephone Number : 419-560-1168
Fax Number :
Authorized Official
Title or Position : CEO
Name : SHAVONTIA SHARROCK
Credential :
Telephone Number : 419-560-1168
Provider Enumeration Date : 10/01/2021
Last Update Date : 10/01/2021

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Directions to “MEDICAL NANNY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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