Individual
LAURA J. SHADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
WHEELING HOSPITAL, 1 MEDICAL PARK, WHEELING, WV 26003
(304) 243-3000
(304) 243-3060
Mailing address
PO BOX 1026, INDIANAPOLIS, IN 46206-1026
(317) 274-1201
(317) 278-9905
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
28193093
IN
363LN0000X
Neonatal Nurse Practitioner
Primary
71004167
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201005360
—
IN
Enumeration date
11/04/2010
Last updated
09/16/2024
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