Provider Demographics
NPI:1245078492
Name:EVANS, SHANEE MICHELE (CNA)
Entity type:Individual
Prefix:
First Name:SHANEE
Middle Name:MICHELE
Last Name:EVANS
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1235 CASSELL VALLEY WAY
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-5697
Mailing Address - Country:US
Mailing Address - Phone:865-865-3388
Mailing Address - Fax:
Practice Address - Street 1:1235 CASSELL VALLEY WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-5697
Practice Address - Country:US
Practice Address - Phone:865-338-8683
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No385H00000XRespite Care FacilityRespite Care