Provider Demographics
NPI:1548873128
Name:SHORKEY, PAMELA D
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:D
Last Name:SHORKEY
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:PO BOX 194
Mailing Address - Street 2:
Mailing Address - City:NELLIS
Mailing Address - State:WV
Mailing Address - Zip Code:25142-0194
Mailing Address - Country:US
Mailing Address - Phone:304-833-2058
Mailing Address - Fax:
Practice Address - Street 1:24 NELLIS CIR
Practice Address - Street 2:
Practice Address - City:NELLIS
Practice Address - State:WV
Practice Address - Zip Code:25142-9781
Practice Address - Country:US
Practice Address - Phone:304-833-2058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-25
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant