Provider Demographics
NPI:1245722248
Name:GILLS, SHANAE
Entity type:Individual
Prefix:
First Name:SHANAE
Middle Name:
Last Name:GILLS
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1565 BRONSON RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-1465
Mailing Address - Country:US
Mailing Address - Phone:330-255-8295
Mailing Address - Fax:
Practice Address - Street 1:1565 BRONSON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-1465
Practice Address - Country:US
Practice Address - Phone:330-255-8295
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-05
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health WorkerGroup - Single Specialty
No374U00000XNursing Service Related ProvidersHome Health Aide