Provider Demographics
NPI:1770007551
Name:STANLEY, SHANIKA LEE (LPN)
Entity Type:Individual
Prefix:
First Name:SHANIKA
Middle Name:LEE
Last Name:STANLEY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8481 CHEVIOT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-2933
Mailing Address - Country:US
Mailing Address - Phone:513-705-1264
Mailing Address - Fax:
Practice Address - Street 1:8481 CHEVIOT RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247-2933
Practice Address - Country:US
Practice Address - Phone:513-705-1264
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH40017510022470A2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2470A2800XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Health InformationAssistant Record TechnicianGroup - Single Specialty