SHANNA ROBERTS
NPI 1417401704
Licensed Practical Nurse in Detroit, MI

Active since August 04, 2016
9366 MANSFIELD ST, DETROIT, MI 48228(313) 879-8546 Get Directions Write a Review

NPPES record last updated: August 4, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Individual
  • Female
  • Licensed Practical Nurse

About SHANNA ROBERTS

This page provides the complete NPI Profile along with additional information for Shanna Roberts, a provider established in Detroit, Michigan with a medical specialization in Licensed Practical Nurse. The healthcare provider is registered in the NPI registry with number 1417401704 assigned on August 2016. The practitioner's primary taxonomy code is 164W00000X with license number 4703111951 (MI). The provider is registered as an individual and her NPI record was last updated 10 years ago.

NPI
1417401704 Verify this NPI
Provider Name
SHANNA ROBERTS
Gender
Female
Entity Type
Individual
Location Address
9366 MANSFIELD ST DETROIT, MI 48228
Location Phone
(313) 879-8546
Mailing Address
9366 MANSFIELD ST DETROIT, MI 48228
Mailing Phone
(313) 879-8546
Is Sole Proprietor?
No
Enumeration Date
08-04-2016
Last Update Date
08-04-2016
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Licensed Practical Nurse

Taxonomy Code
164W00000X
Type
Nursing Service Providers
License No.
4703111951
License State
MI
Taxonomy Description
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.

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Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417401704, enumerated as an "individual" on August 04, 2016.

The provider is located at 9366 MANSFIELD ST DETROIT, MI 48228 and the phone number is (313) 879-8546.

Licensed Practical Nurse with taxonomy code 164W00000X.