Individual
SHANDA NICOLE WHEAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
99 TAVERN RD, MARTINSBURG, WV 25401-2890
(304) 263-4999
Mailing address
PO BOX 1146, MARTINSBURG, WV 25402-1146
(304) 263-4999
(304) 263-4999
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
3039
WV
Other
Enumeration date
06/18/2024
Last updated
06/18/2024
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