Individual
KRISTEN D SHAMBLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
331 LAIDLEY ST, CHARLESTON, WV 25301-1619
(304) 720-7234
(304) 720-7236
Mailing address
7 CHESTNUT LN, SAINT ALBANS, WV 25177-9790
(304) 549-7194
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
63250
WV
363LF0000X
Family Nurse Practitioner
Primary
63250
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295989119
BLUE SHIELD
WV
Enumeration date
11/05/2008
Last updated
12/06/2010
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