Provider Demographics
NPI:1942391503
Name:FLOW, SHANA M (RN)
Entity Type:Individual
Prefix:MISS
First Name:SHANA
Middle Name:M
Last Name:FLOW
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 PARK PL
Mailing Address - Street 2:
Mailing Address - City:HOLLEY
Mailing Address - State:NY
Mailing Address - Zip Code:14470-1022
Mailing Address - Country:US
Mailing Address - Phone:585-638-0915
Mailing Address - Fax:
Practice Address - Street 1:17 PARK PL
Practice Address - Street 2:
Practice Address - City:HOLLEY
Practice Address - State:NY
Practice Address - Zip Code:14470-1022
Practice Address - Country:US
Practice Address - Phone:585-638-0915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY534830163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse