Individual
KEYONA SHINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2101 SILVER MAPLE WAY, LORAIN, OH 44053-2380
(440) 830-3400
(440) 830-3417
Mailing address
2101 SILVER MAPLE WAY, LORAIN, OH 44053-2380
(440) 830-3400
(440) 830-3417
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.436004
OH
207RA0401X
Addiction Medicine (Internal Medicine) Physician
RN.436004
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0419972
—
OH
Enumeration date
10/02/2020
Last updated
09/25/2025
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