Provider Demographics
NPI:1467215293
Name:SHINGLETON, MICHELLE ALEXIS
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:ALEXIS
Last Name:SHINGLETON
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 1:518 SPARTAN LN
Mailing Address - Street 2:
Mailing Address - City:SHANKS
Mailing Address - State:WV
Mailing Address - Zip Code:26761-9047
Mailing Address - Country:US
Mailing Address - Phone:970-756-0180
Mailing Address - Fax:
Practice Address - Street 1:518 SPARTAN LN
Practice Address - Street 2:
Practice Address - City:SHANKS
Practice Address - State:WV
Practice Address - Zip Code:26761-9047
Practice Address - Country:US
Practice Address - Phone:970-756-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant