Provider Demographics
NPI:1639893589
Name:ROBINSON, SHERLANDA MASHAWN
Entity Type:Individual
Prefix:
First Name:SHERLANDA
Middle Name:MASHAWN
Last Name:ROBINSON
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 1:1226 W 11 STREET
Mailing Address - Street 2:
Mailing Address - City:LORAIN
Mailing Address - State:OH
Mailing Address - Zip Code:44052
Mailing Address - Country:US
Mailing Address - Phone:440-258-4740
Mailing Address - Fax:
Practice Address - Street 1:1226 W 11 STREET
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44052
Practice Address - Country:US
Practice Address - Phone:440-258-4740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-03
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X, 172V00000X
OH3962032343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)