Provider Demographics
NPI:1669089959
Name:DUNCAN, SHIRLEY JEAN
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:JEAN
Last Name:DUNCAN
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 1:3213 RALEIGH DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-1855
Mailing Address - Country:US
Mailing Address - Phone:567-698-3246
Mailing Address - Fax:
Practice Address - Street 1:3213 RALEIGH DR
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1855
Practice Address - Country:US
Practice Address - Phone:567-698-3246
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker