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Individual

MRS. KIMBERLY MEADE SHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN, BSN

Contact information

Practice address
506 HOLLY AVE, LOGAN, WV 25601-3306
(304) 752-1804
(304) 852-0207
Mailing address
506 HOLLY AVE, LOGAN, WV 25601-3306
(304) 752-1804
(304) 752-0207

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
47114
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0060164000
WV
Enumeration date
06/10/2008
Last updated
06/10/2008
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