Provider Demographics
NPI:1043404460
Name:VEROSKI, KELLY SHAWN (C-FNP)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:SHAWN
Last Name:VEROSKI
Suffix:
Gender:F
Credentials:C-FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 SIMPSON PL
Mailing Address - Street 2:
Mailing Address - City:POINT PLEASANT
Mailing Address - State:WV
Mailing Address - Zip Code:25550-1626
Mailing Address - Country:US
Mailing Address - Phone:304-675-6880
Mailing Address - Fax:
Practice Address - Street 1:211 6TH ST
Practice Address - Street 2:
Practice Address - City:PARKERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26101-5113
Practice Address - Country:US
Practice Address - Phone:304-485-7374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2007-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV49293363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily