Provider Demographics
NPI:1023510153
Name:TOOLS, SHEVADA
Entity type:Individual
Prefix:
First Name:SHEVADA
Middle Name:
Last Name:TOOLS
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 1:5400 W BERKSHIRE BLVD APT 203
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57106-3611
Mailing Address - Country:US
Mailing Address - Phone:612-227-8347
Mailing Address - Fax:
Practice Address - Street 1:5400 W BERKSHIRE BLVD APT 203
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57106-3611
Practice Address - Country:US
Practice Address - Phone:612-227-8347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-05
Last Update Date:2018-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK119443164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse