Individual
ELLA M SHASTEEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
7591 STATE ROUTE 164, LISBON, OH 44432-9382
(330) 831-2298
(330) 424-5439
Mailing address
7591 STATE ROUTE 164, LISBON, OH 44432-9382
(330) 831-2298
(330) 424-5439
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1500469
MRDD
OH
05
—
2623629
—
OH
Enumeration date
06/13/2006
Last updated
07/08/2007
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