Provider Demographics
NPI:1609627579
Name:SHELOTT, BRITTANY (STNA/CNA)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:SHELOTT
Suffix:
Gender:F
Credentials:STNA/CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:552 WENGLER AVE
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-2929
Mailing Address - Country:US
Mailing Address - Phone:304-276-7432
Mailing Address - Fax:
Practice Address - Street 1:552 WENGLER AVE
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-2929
Practice Address - Country:US
Practice Address - Phone:304-276-7432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH401271070711251E00000X
PA20057557251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health