Provider Demographics
NPI:1962293035
Name:HIXENBAUGH, SHAUNETTE K
Entity type:Individual
Prefix:
First Name:SHAUNETTE
Middle Name:K
Last Name:HIXENBAUGH
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 1:232 4TH ST SE
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-1427
Mailing Address - Country:US
Mailing Address - Phone:330-771-4553
Mailing Address - Fax:330-771-4553
Practice Address - Street 1:232 4TH ST SE
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-1427
Practice Address - Country:US
Practice Address - Phone:330-771-4553
Practice Address - Fax:330-771-4553
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-16
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist