Provider Demographics
NPI:1144077603
Name:ECHOLES, SHAWNTEL C
Entity type:Individual
Prefix:
First Name:SHAWNTEL
Middle Name:C
Last Name:ECHOLES
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 1:10837 GREEN MEADOW PL
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-3531
Mailing Address - Country:US
Mailing Address - Phone:317-282-3808
Mailing Address - Fax:
Practice Address - Street 1:10837 GREEN MEADOW PL
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-3531
Practice Address - Country:US
Practice Address - Phone:317-282-3808
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health