Provider Demographics
NPI:1255028882
Name:SHINKLE, MARIE
Entity type:Individual
Prefix:
First Name:MARIE
Middle Name:
Last Name:SHINKLE
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 1:1876 ABERDEEN RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-1811
Mailing Address - Country:US
Mailing Address - Phone:440-667-2252
Mailing Address - Fax:
Practice Address - Street 1:1876 ABERDEEN RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-1811
Practice Address - Country:US
Practice Address - Phone:440-667-2252
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-24
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Single Specialty