Provider Demographics
NPI:1770724239
Name:SLAY, SHIRLEY JANETTE (STNA/HHA)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:JANETTE
Last Name:SLAY
Suffix:
Gender:F
Credentials:STNA/HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1199 DIAGONAL RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44307-1356
Mailing Address - Country:US
Mailing Address - Phone:330-983-4534
Mailing Address - Fax:
Practice Address - Street 1:1199 DIAGANOL RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44307
Practice Address - Country:US
Practice Address - Phone:330-983-4534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-13
Last Update Date:2009-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH400223090303376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2886426OtherPROVIDER NUMBER
OH1770724239OtherNPI NUMBER