Shannon Leigh Medaris, DNP-FNP

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Shepherdstown, WV

NPI 1649044181 · NPPES record last updated Nov 14, 2023

Key facts

NPI
1649044181
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
318 Leisure Way
Shepherdstown, WV 25443-4169
Phone
(304) 886-8330
NPI assigned
Nov 14, 2023
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

318 Leisure Way
Shepherdstown, WV 25443-4169

Mailing address

318 Leisure Way
Shepherdstown, WV 25443-4169
Phone (304) 886-8330

Other providers in Shepherdstown, WV

All providers in Shepherdstown, WV · Student in an Organized Health Care Education/Training Program in West Virginia

Sources for this page

Verify at the official NPI Registry.