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NPI Code Detail

MEDICARE: MS. SHAWN K CORE FNP-BC

MEDICARE: MS. SHAWN K CORE FNP-BC
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
1363LF0000XFamily Nurse Practitioner51879WV

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1801831250
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHAWN K CORE FNP-BC
Provider Business Mailing Address
First Line : 3 E BENJAMIN DR
Second Line :
City : NEW MARTINSVILLE
State : WV
Zip : 26155-2705
Country : US
Telephone Number : 304-455-8082
Fax Number : 304-455-8165
Provider Business Practice Location Address
First Line : 3 E BENJAMIN DR
Second Line : SUITE B
City : NEW MARTINSVILLE
State : WV
Zip : 26155-2705
Country : US
Telephone Number : 304-455-8082
Fax Number : 304-455-8165
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2006
Last Update Date : 09/10/2014

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