Provider Demographics
NPI:1639747397
Name:SHIVERS, JIOVANNI N
Entity type:Individual
Prefix:MRS
First Name:JIOVANNI
Middle Name:N
Last Name:SHIVERS
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 1:604 W 3RD ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52801-1024
Mailing Address - Country:US
Mailing Address - Phone:563-505-7837
Mailing Address - Fax:
Practice Address - Street 1:604 W 3RD ST APT 2B
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52801-1024
Practice Address - Country:US
Practice Address - Phone:563-505-7837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider