Provider Demographics
NPI:1023872207
Name:VANDENEYNDE, SHAUNA L
Entity type:Individual
Prefix:
First Name:SHAUNA
Middle Name:L
Last Name:VANDENEYNDE
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 1:1105 1ST ST
Mailing Address - Street 2:
Mailing Address - City:FINDLAY
Mailing Address - State:OH
Mailing Address - Zip Code:45840-6415
Mailing Address - Country:US
Mailing Address - Phone:141-989-0712
Mailing Address - Fax:
Practice Address - Street 1:1105 1ST ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-6415
Practice Address - Country:US
Practice Address - Phone:141-989-0712
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-08
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care