Provider Demographics
NPI:1922519859
Name:GRIER, SHAUNTA MARIE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SHAUNTA
Middle Name:MARIE
Last Name:GRIER
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 1:2401 CHEYENNE BLVD
Mailing Address - Street 2:APARTMENT 143
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3726
Mailing Address - Country:US
Mailing Address - Phone:419-770-4072
Mailing Address - Fax:
Practice Address - Street 1:350 S IRWIN STREET
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:OH
Practice Address - Zip Code:43528
Practice Address - Country:US
Practice Address - Phone:567-703-9064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-18
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHQMHS171M00000X
OHLPN.118186.MEDS164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
No171M00000XOther Service ProvidersCase Manager/Care Coordinator