Provider Demographics
NPI:1982391264
Name:SPELLMAN, SHALANA R (LPN, DOULA)
Entity Type:Individual
Prefix:
First Name:SHALANA
Middle Name:R
Last Name:SPELLMAN
Suffix:
Gender:F
Credentials:LPN, DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1445 S CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48638-6337
Mailing Address - Country:US
Mailing Address - Phone:989-501-6672
Mailing Address - Fax:
Practice Address - Street 1:1445 S CENTER RD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48638-6337
Practice Address - Country:US
Practice Address - Phone:989-501-6672
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MINA374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula