Organization
MEDICAL NANNY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAVONTIA SHARROCK (CEO)
(419) 560-1168
Entity
Organization
Contact information
Practice address
1421 LEXINGTON AVE # 268, MANSFIELD, OH 44907-2629
(419) 560-1168
Mailing address
1421 LEXINGTON AVE # 268, MANSFIELD, OH 44907-2629
(419) 560-1168
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
—
—
251E00000X
Home Health Agency
—
—
374U00000X
Home Health Aide
—
—
376K00000X
Nurse's Aide
—
—
Other
Enumeration date
10/01/2021
Last updated
10/01/2021
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