Healthcare Provider Details

I. General information

NPI: 1437029162
Provider Name (Legal Business Name): SHANNON MARIE VINKA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2025
Last Update Date: 01/29/2026
Certification Date: 01/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 MEDICAL PARK
WHEELING WV
26003-6300
US

IV. Provider business mailing address

1 MEDICAL PARK
WHEELING WV
26003-6300
US

V. Phone/Fax

Practice location:
  • Phone: 304-243-3000
  • Fax: 304-312-0815
Mailing address:
  • Phone: 304-243-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number124293
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number124293
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: