Provider Demographics
NPI:1497193007
Name:VEST, SHAWN L (APRN, FNP-BC)
Entity Type:Individual
Prefix:
First Name:SHAWN
Middle Name:L
Last Name:VEST
Suffix:
Gender:M
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 12TH ST
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:WV
Mailing Address - Zip Code:24740-2312
Mailing Address - Country:US
Mailing Address - Phone:304-425-9196
Mailing Address - Fax:
Practice Address - Street 1:702 STAFFORD DR
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:WV
Practice Address - Zip Code:24740-2406
Practice Address - Country:US
Practice Address - Phone:304-425-0085
Practice Address - Fax:304-487-6993
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-06
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV67007363LF0000X
WVAPRN67007-FNP-BC363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily