Provider Demographics
NPI:1457589590
Name:YEAPLES, SHIRLEY JEAN (LPN)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:JEAN
Last Name:YEAPLES
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:246 TOWNSHIP ROAD 481
Mailing Address - Street 2:
Mailing Address - City:SULLIVAN
Mailing Address - State:OH
Mailing Address - Zip Code:44880-9713
Mailing Address - Country:US
Mailing Address - Phone:419-512-3353
Mailing Address - Fax:
Practice Address - Street 1:246 TOWNSHIP ROAD 481
Practice Address - Street 2:
Practice Address - City:SULLIVAN
Practice Address - State:OH
Practice Address - Zip Code:44880-9713
Practice Address - Country:US
Practice Address - Phone:419-512-3353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-28
Last Update Date:2009-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN109570164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse