Provider Demographics
NPI:1295458891
Name:HANSHAW, LORRAINE CHARLETT
Entity type:Individual
Prefix:
First Name:LORRAINE
Middle Name:CHARLETT
Last Name:HANSHAW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:254 JARRELL AVE
Mailing Address - Street 2:
Mailing Address - City:WHITESVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25209
Mailing Address - Country:US
Mailing Address - Phone:304-854-3915
Mailing Address - Fax:
Practice Address - Street 1:254 JARRELL AVE
Practice Address - Street 2:
Practice Address - City:WHITESVILLE
Practice Address - State:WV
Practice Address - Zip Code:25209
Practice Address - Country:US
Practice Address - Phone:304-854-3915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-20
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant