Provider Demographics
NPI:1831866672
Name:ELIEN, SHEVON SHEVELLE (OWNER)
Entity type:Individual
Prefix:
First Name:SHEVON
Middle Name:SHEVELLE
Last Name:ELIEN
Suffix:
Gender:F
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:780 PIPERS CAY DR
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-4013
Mailing Address - Country:US
Mailing Address - Phone:561-503-6068
Mailing Address - Fax:
Practice Address - Street 1:780 PIPERS CAY DR
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-4013
Practice Address - Country:US
Practice Address - Phone:561-503-6068
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-28
Last Update Date:2021-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide