Provider Demographics
NPI:1407432685
Name:SHAFER-CORNETT, ANEDRA L (BS,QMHS)
Entity Type:Individual
Prefix:MRS
First Name:ANEDRA
Middle Name:L
Last Name:SHAFER-CORNETT
Suffix:
Gender:F
Credentials:BS,QMHS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 EAST 1ST ST
Mailing Address - Street 2:#53
Mailing Address - City:SILVER GROVE
Mailing Address - State:KY
Mailing Address - Zip Code:41085-0053
Mailing Address - Country:US
Mailing Address - Phone:859-512-2290
Mailing Address - Fax:
Practice Address - Street 1:400 OAK ST
Practice Address - Street 2:7TH FLOOR, OHIORISE
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:513-808-0363
Practice Address - Fax:513-636-3579
Is Sole Proprietor?:No
Enumeration Date:2021-03-19
Last Update Date:2022-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator