Provider Demographics
NPI:1871197251
Name:BAYS, SHANNA SUE
Entity Type:Individual
Prefix:
First Name:SHANNA
Middle Name:SUE
Last Name:BAYS
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 1:4376 STATE ROUTE 19
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-9382
Mailing Address - Country:US
Mailing Address - Phone:419-569-1203
Mailing Address - Fax:
Practice Address - Street 1:4376 SR 19
Practice Address - Street 2:
Practice Address - City:BUCYRUS
Practice Address - State:OH
Practice Address - Zip Code:44820-4482
Practice Address - Country:US
Practice Address - Phone:419-569-1203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-25
Last Update Date:2020-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant