Provider Demographics
NPI:1114639481
Name:JOHNS, SHANLETTE MARIE (CNA 2101970 IN)
Entity Type:Individual
Prefix:
First Name:SHANLETTE
Middle Name:MARIE
Last Name:JOHNS
Suffix:
Gender:F
Credentials:CNA 2101970 IN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 CASS CT
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-5631
Mailing Address - Country:US
Mailing Address - Phone:800-318-9107
Mailing Address - Fax:888-668-4173
Practice Address - Street 1:1636 CASS CT
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-5631
Practice Address - Country:US
Practice Address - Phone:800-318-9107
Practice Address - Fax:888-668-4173
Is Sole Proprietor?:Yes
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion
No376J00000XNursing Service Related ProvidersHomemaker