Provider Demographics
NPI:1740095421
Name:SHELVIN, RASHEEDAH KALEELAH
Entity type:Individual
Prefix:
First Name:RASHEEDAH
Middle Name:KALEELAH
Last Name:SHELVIN
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 1:1954 AIRPORT RD # 1392
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-4956
Mailing Address - Country:US
Mailing Address - Phone:620-542-9142
Mailing Address - Fax:
Practice Address - Street 1:6081 W MAIN ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-1719
Practice Address - Country:US
Practice Address - Phone:620-542-9142
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier