Provider Demographics
NPI:1013898642
Name:HANSHAW, MARILYN SARALEE
Entity type:Individual
Prefix:
First Name:MARILYN
Middle Name:SARALEE
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 1:100 ELKINS CV APT B1
Mailing Address - Street 2:
Mailing Address - City:OCEANA
Mailing Address - State:WV
Mailing Address - Zip Code:24870-9605
Mailing Address - Country:US
Mailing Address - Phone:304-585-3740
Mailing Address - Fax:
Practice Address - Street 1:4773 KOPPERSTON ST
Practice Address - Street 2:LOT 114
Practice Address - City:KOPPERSTON
Practice Address - State:WV
Practice Address - Zip Code:24854
Practice Address - Country:US
Practice Address - Phone:304-585-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-10
Last Update Date:2025-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant