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Individual

SHELLY DENISE PACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
3997 BECKLEY RD, PRINCETON, WV 24740-7660
(304) 431-5499
Mailing address
568 LEAH DR, PRINCETON, WV 24739-9017
(304) 920-1954

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
64418
WV
363LF0000X
Family Nurse Practitioner
Primary
113688
WV

Other

Enumeration date
05/11/2022
Last updated
07/16/2022
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