Provider Demographics
NPI:1538551312
Name:VANDERBILT-SHIFFLET, CARI SUE
Entity type:Individual
Prefix:MISS
First Name:CARI
Middle Name:SUE
Last Name:VANDERBILT-SHIFFLET
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 1:3330 MOONRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45248-4212
Mailing Address - Country:US
Mailing Address - Phone:513-578-3210
Mailing Address - Fax:
Practice Address - Street 1:3330 MOONRIDGE DR
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45248-4212
Practice Address - Country:US
Practice Address - Phone:513-578-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide