Provider Demographics
NPI:1558122713
Name:LUCE, SHEENA MARIE (BA)
Entity Type:Individual
Prefix:
First Name:SHEENA
Middle Name:MARIE
Last Name:LUCE
Suffix:
Gender:F
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3383 EAGLE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LEAVITTSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44430-9413
Mailing Address - Country:US
Mailing Address - Phone:440-813-4025
Mailing Address - Fax:
Practice Address - Street 1:3383 EAGLE CREEK RD
Practice Address - Street 2:
Practice Address - City:LEAVITTSBURG
Practice Address - State:OH
Practice Address - Zip Code:44430-9413
Practice Address - Country:US
Practice Address - Phone:440-813-4025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-16
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant