Provider Demographics
NPI:1245010602
Name:MUSICK-HEID, SHAWANNA LYNN (RN)
Entity type:Individual
Prefix:
First Name:SHAWANNA
Middle Name:LYNN
Last Name:MUSICK-HEID
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3175 NORSE RD NE # NEE
Mailing Address - Street 2:
Mailing Address - City:SALINEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43945-9427
Mailing Address - Country:US
Mailing Address - Phone:330-447-0953
Mailing Address - Fax:330-420-0118
Practice Address - Street 1:8473 COUNTY HOME RD
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-9418
Practice Address - Country:US
Practice Address - Phone:330-424-4065
Practice Address - Fax:330-420-0118
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-03
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN327163163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator