Provider Demographics
NPI:1447643226
Name:CANTRELL, SHILAH (RN)
Entity type:Individual
Prefix:MS
First Name:SHILAH
Middle Name:
Last Name:CANTRELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 W CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-4260
Mailing Address - Country:US
Mailing Address - Phone:740-485-4083
Mailing Address - Fax:
Practice Address - Street 1:265 W CHURCH ST
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-4260
Practice Address - Country:US
Practice Address - Phone:740-485-4083
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-18
Last Update Date:2015-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH388083163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse