Provider Demographics
NPI:1558970814
Name:RANSBOTTOM, SHELLEY R
Entity Type:Individual
Prefix:
First Name:SHELLEY
Middle Name:R
Last Name:RANSBOTTOM
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 1:218 2ND AVE
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:OH
Mailing Address - Zip Code:45619-1234
Mailing Address - Country:US
Mailing Address - Phone:740-612-9755
Mailing Address - Fax:
Practice Address - Street 1:218 2ND AVE
Practice Address - Street 2:
Practice Address - City:CHESAPEAKE
Practice Address - State:OH
Practice Address - Zip Code:45619-1234
Practice Address - Country:US
Practice Address - Phone:740-612-9755
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-23
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant