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NPI Code Detail

MEDICARE: SHAYLA WILLIAMS

MEDICARE: SHAYLA WILLIAMS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376J00000XHomemaker
23747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1073398913
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAYLA WILLIAMS
Provider Business Mailing Address
First Line : 180 WELLNESS DR
Second Line :
City : SUMMERSVILLE
State : WV
Zip : 26651-5401
Country : US
Telephone Number : 48-720-0583
Fax Number : 304-872-0116
Provider Business Practice Location Address
First Line : 180 WELLNESS DR
Second Line :
City : SUMMERSVILLE
State : WV
Zip : 26651-5401
Country : US
Telephone Number : 304-872-0058
Fax Number : 304-872-1006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2023
Last Update Date : 01/10/2025

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