Provider Demographics
NPI:1730958174
Name:SHIELDS, ANNIE MARIA
Entity type:Individual
Prefix:MISS
First Name:ANNIE
Middle Name:MARIA
Last Name:SHIELDS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2507 ASPEN ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:OH
Mailing Address - Zip Code:45042-1801
Mailing Address - Country:US
Mailing Address - Phone:513-320-2390
Mailing Address - Fax:
Practice Address - Street 1:2507 ASPEN ST
Practice Address - Street 2:
Practice Address - City:MIDDLETOWN
Practice Address - State:OH
Practice Address - Zip Code:45042-1801
Practice Address - Country:US
Practice Address - Phone:513-320-2390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-27
Last Update Date:2023-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health