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General NPI Number Information
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NPI Number | 1578576807
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Entity Type | Individual
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Provider Name | SHELLY E. WILLHAM CFNP
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Gender | Female
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Dates
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Enumeration Date | 08/15/2006
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Last Update Date | 01/02/2025
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Provider Practice Location Address
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Address Line | 601 AVERY ST STE 500
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City | PARKERSBURG
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State | WV
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Zip | 26101-5111
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Country | US
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Telephone | 330-348-3664
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Fax |
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Provider Business Mailing Address
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Address Line | 601 AVERY ST STE 500
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City | PARKERSBURG
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State | WV
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Zip | 26101-5111
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Country | US
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Telephone | 304-372-2731
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Fax | 304-372-2749
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 57551
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License Number State | WV
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