Provider Demographics
NPI:1730079559
Name:SHINGLETON, BRIAN
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:SHINGLETON
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:735 ROCKY FORK RD
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:WV
Mailing Address - Zip Code:26412-8226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:735 ROCKY FORK RD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:WV
Practice Address - Zip Code:26412-8226
Practice Address - Country:US
Practice Address - Phone:304-439-8369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide