Provider Demographics
NPI:1073377768
Name:AUSTIN, SHONTEL SHEREE (CNA)
Entity Type:Individual
Prefix:
First Name:SHONTEL
Middle Name:SHEREE
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1539 REDMAN BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63138-2547
Mailing Address - Country:US
Mailing Address - Phone:618-419-3883
Mailing Address - Fax:
Practice Address - Street 1:1539 REDMAN BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63138-2547
Practice Address - Country:US
Practice Address - Phone:618-419-3883
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-12
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care