Provider Demographics
NPI:1902032337
Name:CRITES, SHAWNA R (RN)
Entity Type:Individual
Prefix:MRS
First Name:SHAWNA
Middle Name:R
Last Name:CRITES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:411 SPRING AVE.
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26836
Mailing Address - Country:US
Mailing Address - Phone:304-530-6355
Mailing Address - Fax:304-530-7684
Practice Address - Street 1:411 SPRING AVE.
Practice Address - Street 2:SUITE 101
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836
Practice Address - Country:US
Practice Address - Phone:304-530-6355
Practice Address - Fax:304-530-7684
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV55073163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse