Provider Demographics
NPI:1801612551
Name:SHANEYFELT, CINSEARARAY ANGEL (ATTENDANT CARE AND H)
Entity type:Individual
Prefix:MRS
First Name:CINSEARARAY
Middle Name:ANGEL
Last Name:SHANEYFELT
Suffix:
Gender:F
Credentials:ATTENDANT CARE AND H
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6185 STOCKSDALE RD
Mailing Address - Street 2:
Mailing Address - City:UNION CITY
Mailing Address - State:OH
Mailing Address - Zip Code:45390-8806
Mailing Address - Country:US
Mailing Address - Phone:937-564-8050
Mailing Address - Fax:
Practice Address - Street 1:6185 STOCKSDALE RD
Practice Address - Street 2:
Practice Address - City:UNION CITY
Practice Address - State:OH
Practice Address - Zip Code:45390-8806
Practice Address - Country:US
Practice Address - Phone:937-564-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-26
Last Update Date:2024-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
374U00000X
IN374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide