Provider Demographics
NPI:1518795277
Name:BARKER, SHAWNDA
Entity type:Individual
Prefix:
First Name:SHAWNDA
Middle Name:
Last Name:BARKER
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 1:18 SHEPPARDS LN
Mailing Address - Street 2:
Mailing Address - City:BIG CREEK
Mailing Address - State:WV
Mailing Address - Zip Code:25505-8006
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:647 MAIN ST APT 508
Practice Address - Street 2:
Practice Address - City:CHAPMANVILLE
Practice Address - State:WV
Practice Address - Zip Code:25508-5010
Practice Address - Country:US
Practice Address - Phone:681-357-2667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide