Healthcare Provider Details

I. General information

NPI: 1720395742
Provider Name (Legal Business Name): MS. KELLY ANANDI SHEKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/13/2010
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 AMHERST ST
WINCHESTER VA
22601-2808
US

IV. Provider business mailing address

20 BUFFALO RUN TRL
BERKELEY SPRINGS WV
25411-5749
US

V. Phone/Fax

Practice location:
  • Phone: 540-536-8000
  • Fax:
Mailing address:
  • Phone: 763-548-4024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number90309
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: