Provider Demographics
NPI:1366070278
Name:CARUSO-FIELDS, SHANNON (APRN)
Entity type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:CARUSO-FIELDS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1398 OBERTING RD
Mailing Address - Street 2:
Mailing Address - City:GREENDALE
Mailing Address - State:IN
Mailing Address - Zip Code:47025-9453
Mailing Address - Country:US
Mailing Address - Phone:513-560-2904
Mailing Address - Fax:
Practice Address - Street 1:10548 HARRISON AVE STE 2000
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-2902
Practice Address - Country:US
Practice Address - Phone:513-560-2904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-28
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.026177363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily