Individual
SHANNA HALTERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11 NORTH AVE, PETERSBURG, WV 26847-1631
(304) 851-0968
Mailing address
11 NORTH AVE, PETERSBURG, WV 26847-1631
(304) 851-0968
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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