Provider Demographics
NPI:1730582487
Name:GARNER, SHAMYRE LYNN (BSW, LSW, RN)
Entity type:Individual
Prefix:
First Name:SHAMYRE
Middle Name:LYNN
Last Name:GARNER
Suffix:
Gender:F
Credentials:BSW, LSW, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3170 W CENTRAL AVE STE B
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-2945
Mailing Address - Country:US
Mailing Address - Phone:567-316-7253
Mailing Address - Fax:567-316-7232
Practice Address - Street 1:3170 W CENTRAL AVE STE B
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-2945
Practice Address - Country:US
Practice Address - Phone:567-316-7253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-08
Last Update Date:2023-07-10
Deactivation Date:2020-12-26
Deactivation Code:
Reactivation Date:2023-06-29
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
OH466490163W00000X
OHRN.466490163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No163W00000XNursing Service ProvidersRegistered Nurse