MEDICARE: AMANDA LEE SHREWSBERRY

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
1	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1578410189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA LEE SHREWSBERRY

Provider Business Mailing Address
First Line	:	PO BOX 146
Second Line	:
City	:	PRINCETON
State	:	WV
Zip	:	24740-0146
Country	:	US
Telephone Number	:	681-775-2992
Fax Number	:

Provider Business Practice Location Address
First Line	:	190 BEECHTREE ST
Second Line	:
City	:	PRINCETON
State	:	WV
Zip	:	24739-6942
Country	:	US
Telephone Number	:	681-775-9104
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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