Provider Demographics
NPI:1700167558
Name:WILEY, SHARON KAYE (FNP)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:KAYE
Last Name:WILEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:SHARI
Other - Middle Name:
Other - Last Name:WILEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:PO BOX 4190
Mailing Address - Street 2:
Mailing Address - City:BARBOURSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25504-4190
Mailing Address - Country:US
Mailing Address - Phone:304-399-4405
Mailing Address - Fax:304-399-2526
Practice Address - Street 1:2900 1ST AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25702-1241
Practice Address - Country:US
Practice Address - Phone:304-526-6029
Practice Address - Fax:304-526-8795
Is Sole Proprietor?:No
Enumeration Date:2011-09-07
Last Update Date:2023-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV40524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily