Provider Demographics
NPI:1629549050
Name:THURMOND, SHEENA (RN,MSN)
Entity Type:Individual
Prefix:MRS
First Name:SHEENA
Middle Name:
Last Name:THURMOND
Suffix:
Gender:F
Credentials:RN,MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3906 OTIS DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45416-1934
Mailing Address - Country:US
Mailing Address - Phone:513-319-9511
Mailing Address - Fax:
Practice Address - Street 1:3906 OTIS DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45416-1934
Practice Address - Country:US
Practice Address - Phone:513-319-9511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-11
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN340370163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse