MEDICARE: EDAYSHANEE ERVIN

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	172A00000X	Driver
2	374U00000X	Home Health Aide
3	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1699669994
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDAYSHANEE ERVIN

Provider Business Mailing Address
First Line	:	1321 VINE ST APT 11
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-7148
Country	:	US
Telephone Number	:	513-578-1626
Fax Number	:

Provider Business Practice Location Address
First Line	:	1321 VINE ST APT 11
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-7148
Country	:	US
Telephone Number	:	513-578-1626
Fax Number	:

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

Provider Enumeration Date	:	06/03/2025
Last Update Date	:	06/03/2025

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Directions to “ EDAYSHANEE ERVIN ” Practice Location

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