Blake, Shawny Jerretta

Blake, Shawny Jerretta is an sole proprietor health care provider with primary practice located at 913B Saint Francis St , Kennett MO 63857-1779. She recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as her primary health care specialty. Blake, Shawny Jerretta can be contacted via phone (573) 888-9881.

Contact Information

Primary practice address
913B Saint Francis St Kennett MO 63857-1779
Phone: (573) 888-9881
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X 1003 Missouri

Profile Details

NPI number 1013142207
LBN Legal business name Blake, Shawny Jerretta
Credentials BCHIS
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 18th, 2009
Last updated May 18th, 2009 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013142207 NPPES
Missouri Other 401516 BLUE CROSS AND BLUE SHIELD

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