Healthcare Provider Details

I. General information

NPI: 1699482091
Provider Name (Legal Business Name): KENNEDIE SHANTAL SHIRLEY HINGER BSN,RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2022
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 204
MOOREFIELD WV
26836-0204
US

IV. Provider business mailing address

PO BOX 204
MOOREFIELD WV
26836-0204
US

V. Phone/Fax

Practice location:
  • Phone: 304-851-3060
  • Fax:
Mailing address:
  • Phone: 304-851-3060
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: