Provider Demographics
NPI:1649021254
Name:MSHAR, ALETHEA J
Entity type:Individual
Prefix:
First Name:ALETHEA
Middle Name:J
Last Name:MSHAR
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 1:8275 COUNTY ROAD 612
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:MI
Mailing Address - Zip Code:49756-9107
Mailing Address - Country:US
Mailing Address - Phone:616-745-4703
Mailing Address - Fax:
Practice Address - Street 1:8275 COUNTY ROAD 612
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:MI
Practice Address - Zip Code:49756-9107
Practice Address - Country:US
Practice Address - Phone:616-745-4703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-01
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion