Provider Demographics
NPI:1033994892
Name:WHATLEY, SHARENDA
Entity Type:Individual
Prefix:
First Name:SHARENDA
Middle Name:
Last Name:WHATLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37 W HEIGHTS AVE
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44509-2312
Mailing Address - Country:US
Mailing Address - Phone:216-801-9022
Mailing Address - Fax:
Practice Address - Street 1:37 W HEIGHTS AVE
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44509-2312
Practice Address - Country:US
Practice Address - Phone:216-801-9022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty