Individual
CHARLENE SHANNON-BENNETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
17731 LAKE SHORE BLVD APT 15, CLEVELAND, OH 44119-2600
(216) 420-3655
Mailing address
17731 LAKE SHORE BLVD APT 15, CLEVELAND, OH 44119-2600
(216) 420-3655
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
401217520311
OH
Other
Enumeration date
05/15/2017
Last updated
07/21/2022
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