Shaelyn Braenovich

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

119461 Issued in WV

Practice address

175 Philpott LN
Beaver, WV 25813-9501

Phone

(304) 254-9262

NPI assigned

Feb 1, 2023

Last updated

Sep 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1675209600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1417653585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 PHILPOTT LN",
            "city": "BEAVER",
            "state": "WV",
            "postal_code": "258139501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 PHILPOTT LN",
            "city": "BEAVER",
            "state": "WV",
            "postal_code": "258139501",
            "telephone_number": "304-254-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRAENOVICH",
        "first_name": "SHAELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-01",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WV",
            "license": "119461",
            "primary": true
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WV",
            "license": "39816",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "39816",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Bolen, FNP
• Krista Bowling
• Jill A Boyce, MD
• Lauren Boyd
• Tiziana Rae Bradley
• Ashley Bragg
• Darlene Bragg
• Kirsten Jo Bragg
• Lori Michelle Brown
• Jodi Browning, PHARM D

• Registered Nurse in Beaver, WV
• Providers in Beaver, WV by specialty
• Registered Nurse in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.