Provider Demographics
NPI:1922457258
Name:SIEREN, SHAWNA
Entity Type:Individual
Prefix:
First Name:SHAWNA
Middle Name:
Last Name:SIEREN
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 1:1406 210TH ST
Mailing Address - Street 2:
Mailing Address - City:KEOTA
Mailing Address - State:IA
Mailing Address - Zip Code:52248-9270
Mailing Address - Country:US
Mailing Address - Phone:319-461-8363
Mailing Address - Fax:
Practice Address - Street 1:1406 210TH ST
Practice Address - Street 2:
Practice Address - City:KEOTA
Practice Address - State:IA
Practice Address - Zip Code:52248-9270
Practice Address - Country:US
Practice Address - Phone:319-461-8363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer