Provider Demographics
NPI:1134859812
Name:BARRETT, SHANE
Entity type:Individual
Prefix:
First Name:SHANE
Middle Name:
Last Name:BARRETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2013 SILVERDALE DR
Mailing Address - Street 2:
Mailing Address - City:FINLEYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15332-1531
Mailing Address - Country:US
Mailing Address - Phone:412-609-8565
Mailing Address - Fax:
Practice Address - Street 1:2013 SILVERDALE DR
Practice Address - Street 2:
Practice Address - City:FINLEYVILLE
Practice Address - State:PA
Practice Address - Zip Code:15332-1531
Practice Address - Country:US
Practice Address - Phone:412-609-8565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-15
Last Update Date:2022-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program