Taryn Renee Shackle
Individual provider Active NPI Home Health Aide · Brewster, OH
NPI 1093574113 · NPPES record last updated Mar 19, 2024
Key facts
- NPI
- 1093574113
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Home Health Aide 374U00000X
- Practice address
- 463 Mohican St NE
Brewster, OH 44613 - Phone
- (330) 312-2307
- NPI assigned
- Mar 19, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Aide | 374U00000X | Yes |
Addresses
Primary practice location
463 Mohican St NE
Brewster, OH 44613
Mailing address
463 Mohican St NE
Brewster, OH 44613
Phone (330) 312-2307
Other providers in Brewster, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 19, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.