Provider Demographics
NPI:1790372423
Name:SHAVERS, SANDRA D (HEALTH CARE PROVIDER)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:D
Last Name:SHAVERS
Suffix:
Gender:F
Credentials:HEALTH CARE PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 E CATAWBA AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44306-3665
Mailing Address - Country:US
Mailing Address - Phone:330-376-4518
Mailing Address - Fax:
Practice Address - Street 1:554 WEST AVE APT 206
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-1773
Practice Address - Country:US
Practice Address - Phone:133-056-4771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide