Provider Demographics
NPI:1013419670
Name:SUGGS, SHENELLE (LPN)
Entity Type:Individual
Prefix:
First Name:SHENELLE
Middle Name:
Last Name:SUGGS
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 1:10011 ANDERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-2215
Mailing Address - Country:US
Mailing Address - Phone:216-785-3014
Mailing Address - Fax:
Practice Address - Street 1:10011 ANDERSON AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44105-2215
Practice Address - Country:US
Practice Address - Phone:216-785-3014
Practice Address - Fax:216-785-3014
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH153090164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH153090OtherNURSING