Provider Demographics
NPI:1760031744
Name:SHIMUNEC, MARJORIE
Entity Type:Individual
Prefix:
First Name:MARJORIE
Middle Name:
Last Name:SHIMUNEC
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 1:163 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:ELSIE
Mailing Address - State:MI
Mailing Address - Zip Code:48831
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:163 W ELM ST
Practice Address - Street 2:
Practice Address - City:ELSIE
Practice Address - State:MI
Practice Address - Zip Code:48831
Practice Address - Country:US
Practice Address - Phone:989-862-1630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-11
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider