=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982402582
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SHARLENE O'DAY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2025
-----------------------------------------------------
Last Update Date | 03/07/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 900 VIRGINIA ST E STE 400
-----------------------------------------------------
City | CHARLESTON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 25301-2835
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 681-313-4759
-----------------------------------------------------
Fax | 844-800-3954
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 505 CADES FIELD DR
-----------------------------------------------------
City | UNION
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 24983-6401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-994-0205
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163W00000X
-----------------------------------------------------
Taxonomy Name | Registered Nurse
-----------------------------------------------------
License Number | 79673
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------