Devona K Shelton, LPN

Individual provider Active NPI Licensed Practical Nurse · Winchester, OH

NPI 1740534874 · NPPES record last updated Oct 26, 2012

Key facts

NPI
1740534874
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
150425-M-IV (OH)
Practice address
22410 State Route 136
Winchester, OH 45697-9733
Phone
(937) 695-0024
NPI assigned
Oct 26, 2012
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

State licenses

LicenseStateTypeSpecialty
150425-M-IVOHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 150425-M-IV OH Yes

Addresses

Primary practice location

22410 State Route 136
Winchester, OH 45697-9733

Mailing address

22410 State Route 136
Winchester, OH 45697-9733
Phone (937) 695-0024

Other providers in Winchester, OH

All providers in Winchester, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.