Provider Demographics
NPI:1477623015
Name:WORKMAN, SHELBA JEAN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:SHELBA
Middle Name:JEAN
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:MS
Other - First Name:SHELBA
Other - Middle Name:JEAN
Other - Last Name:LONG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3375 US RT 60
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25705-2837
Mailing Address - Country:US
Mailing Address - Phone:304-525-7851
Mailing Address - Fax:304-586-0671
Practice Address - Street 1:376 KENMORE DRIVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25053
Practice Address - Country:US
Practice Address - Phone:304-525-7851
Practice Address - Fax:304-369-1978
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV0274623363L00000X
WV38119363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0005355002Medicaid
KY78004710Medicaid
WV9600149000Medicaid
WVLONP11591Medicare ID - Type Unspecified
WV9600149000Medicaid