Provider Demographics
NPI:1518641778
Name:LEGAIR, SHANNAN D
Entity Type:Individual
Prefix:
First Name:SHANNAN
Middle Name:D
Last Name:LEGAIR
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 1:532 COURTRIGHT CT
Mailing Address - Street 2:
Mailing Address - City:PICKERINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43147-8781
Mailing Address - Country:US
Mailing Address - Phone:614-302-6766
Mailing Address - Fax:
Practice Address - Street 1:1021 CHECKREIN AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43229-1106
Practice Address - Country:US
Practice Address - Phone:614-844-3800
Practice Address - Fax:614-844-6258
Is Sole Proprietor?:No
Enumeration Date:2023-06-09
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator