Provider Demographics
NPI:1407736622
Name:SHANNYS
Entity type:Organization
Organization Name:SHANNYS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHANNON
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:BUSSEY
Authorized Official - Suffix:
Authorized Official - Credentials:HOME CARE AID
Authorized Official - Phone:231-233-7751
Mailing Address - Street 1:1965 W CONRAD RD
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-9313
Mailing Address - Country:US
Mailing Address - Phone:231-233-7751
Mailing Address - Fax:
Practice Address - Street 1:1965 W CONRAD RD
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-9313
Practice Address - Country:US
Practice Address - Phone:231-233-7751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-08
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty