Provider Demographics
NPI:1376145185
Name:YARBROUGH, SHATON DENISE
Entity Type:Individual
Prefix:
First Name:SHATON
Middle Name:DENISE
Last Name:YARBROUGH
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 1:3096 WHITE ASH DR
Mailing Address - Street 2:
Mailing Address - City:TIPP CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45371-2592
Mailing Address - Country:US
Mailing Address - Phone:937-554-3729
Mailing Address - Fax:
Practice Address - Street 1:3096 WHITE ASH DR
Practice Address - Street 2:
Practice Address - City:TIPP CITY
Practice Address - State:OH
Practice Address - Zip Code:45371-2592
Practice Address - Country:US
Practice Address - Phone:937-554-3729
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-16
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347E00000XTransportation ServicesTransportation Broker