Randi Ganoe Gillette
Individual provider Active NPI Personal Care Attendant · Shade, OH
NPI 1700930997 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1700930997
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 40295 Burlingham Road
Shade, OH 45776 - Phone
- (740) 696-0068
- NPI assigned
- Jan 23, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
40295 Burlingham Road
Shade, OH 45776
Mailing address
40295 Burlingham Road
Shade, OH 45776
Phone (740) 696-0068
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2353117 | Medicaid | OH |
Other providers in Shade, OH
- Jesse Arra Gillette
- Tayler Lynn Grueser
- Judy L Jackson
- Virginia A Patton
- Christina Marie Sanborn
- Erin Elizabeth Thomas
All providers in Shade, OH · Personal Care Attendant in Ohio
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. 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.