MEDICARE: MISS CARI SUE VANDERBILT-SHIFFLET

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
1	374U00000X	Home Health Aide

General Provider Information

NPI Number	:	1538551312
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS CARI SUE VANDERBILT-SHIFFLET

Provider Business Mailing Address
First Line	:	3330 MOONRIDGE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-4212
Country	:	US
Telephone Number	:	513-578-3210
Fax Number	:

Provider Business Practice Location Address
First Line	:	3330 MOONRIDGE DR
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45248-4212
Country	:	US
Telephone Number	:	513-578-3210
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/03/2015
Last Update Date	:	03/03/2015

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Directions to “ MISS CARI SUE VANDERBILT-SHIFFLET ” Practice Location

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