Provider Demographics
NPI:1033704648
Name:EARLS, SHELBY LYNN
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:LYNN
Last Name:EARLS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 SAND MINE RD STE 1
Mailing Address - Street 2:
Mailing Address - City:BERKELEY SPRINGS
Mailing Address - State:WV
Mailing Address - Zip Code:25411-7457
Mailing Address - Country:US
Mailing Address - Phone:304-258-3096
Mailing Address - Fax:304-258-3190
Practice Address - Street 1:SENIOR LIFE SERVICES OF MORGAN COUNTY
Practice Address - Street 2:106 SAND MINE RD SUITE 1
Practice Address - City:BERKELEY SPRINGS
Practice Address - State:WV
Practice Address - Zip Code:25411-2541
Practice Address - Country:US
Practice Address - Phone:304-258-3096
Practice Address - Fax:304-258-3190
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV94515163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse