Provider Demographics
NPI:1215217617
Name:SHIRK, ANGELA RENEE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:RENEE
Last Name:SHIRK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:506 ELM ST.
Mailing Address - Street 2:PO BOX 137
Mailing Address - City:MCGUFFEY
Mailing Address - State:OH
Mailing Address - Zip Code:45859
Mailing Address - Country:US
Mailing Address - Phone:567-825-3192
Mailing Address - Fax:
Practice Address - Street 1:506 ELM ST.
Practice Address - Street 2:
Practice Address - City:MCGUFFEY
Practice Address - State:OH
Practice Address - Zip Code:45859
Practice Address - Country:US
Practice Address - Phone:567-825-3192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH358304163WH0200X, 163W00000X, 163WG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WG0600XNursing Service ProvidersRegistered NurseGerontology