Healthcare Provider Details

I. General information

NPI: 1144561432
Provider Name (Legal Business Name): JOSHUA L SHREWSBERY FNP- BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2013
Last Update Date: 07/06/2023
Certification Date: 07/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11950 MACCORKLE AVE
CHESAPEAKE WV
25315-1135
US

IV. Provider business mailing address

252 RURAL ACRES DR
BECKLEY WV
25801-3503
US

V. Phone/Fax

Practice location:
  • Phone: 304-220-2111
  • Fax: 304-220-2183
Mailing address:
  • Phone: 304-252-8324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number68843
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: