Provider Demographics
NPI:1962649137
Name:MASHISKA, SHAREECE LA'SHEA (LPN)
Entity Type:Individual
Prefix:MRS
First Name:SHAREECE
Middle Name:LA'SHEA
Last Name:MASHISKA
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 1:167 S BEVERLY AVE
Mailing Address - Street 2:
Mailing Address - City:AUSTINTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-3540
Mailing Address - Country:US
Mailing Address - Phone:330-792-9507
Mailing Address - Fax:
Practice Address - Street 1:167 S BEVERLY AVE
Practice Address - Street 2:
Practice Address - City:AUSTINTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-3540
Practice Address - Country:US
Practice Address - Phone:330-792-9507
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-09
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH116060164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse