Individual
JENNIFER A SHAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6981 BRECKENWOOD DR, DAYTON, OH 45424-7326
(937) 602-1636
(937) 528-2156
Mailing address
7340 BRANDTVISTA AVE, DAYTON, OH 45424-3331
(937) 602-1636
(937) 528-2156
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN-231005
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2644133
—
OH
Enumeration date
05/02/2007
Last updated
02/28/2022
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