Shantelle Weaver
Individual provider Active NPI In Home Supportive Care Agency · Sequatchie, TN
NPI 1487436895 · NPPES record last updated Oct 19, 2023
Key facts
- NPI
- 1487436895
- Entity type
- Individual (NPI type 1)
- Primary specialty
- In Home Supportive Care Agency 253Z00000X
- Practice address
- 545 Ann Wilson Rd
Sequatchie, TN 37374-6060 - Phone
- (423) 713-8137
- NPI assigned
- Oct 19, 2023
- 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 |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | Yes |
Addresses
Primary practice location
545 Ann Wilson Rd
Sequatchie, TN 37374-6060
Mailing address
545 Ann Wilson Rd
Sequatchie, TN 37374-6060
Phone (423) 713-8137
Other providers in Sequatchie, TN
All providers in Sequatchie, TN · In Home Supportive Care Agency in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 19, 2023. 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.