Provider Demographics
NPI:1194398198
Name:SHESTINA, ASHLEY LAUREN (LPN)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LAUREN
Last Name:SHESTINA
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6237 ALEXANDRIA DR
Mailing Address - Street 2:
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-2845
Mailing Address - Country:US
Mailing Address - Phone:216-554-5934
Mailing Address - Fax:
Practice Address - Street 1:6237 ALEXANDRIA DR
Practice Address - Street 2:
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-2845
Practice Address - Country:US
Practice Address - Phone:216-554-5934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-19
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.172377.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse