Provider Demographics
NPI:1437745122
Name:SHOENFELT, JOAN
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:SHOENFELT
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 1:28 STATE ST
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1346
Mailing Address - Country:US
Mailing Address - Phone:419-545-2711
Mailing Address - Fax:
Practice Address - Street 1:28 STATE ST
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1346
Practice Address - Country:US
Practice Address - Phone:419-545-2711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-16
Last Update Date:2020-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty