Provider Demographics
NPI:1215081013
Name:LANHAM RENEE, SHAWN (REGISTERED NURSE)
Entity type:Individual
Prefix:MRS
First Name:SHAWN
Middle Name:
Last Name:LANHAM RENEE
Suffix:
Gender:F
Credentials:REGISTERED NURSE
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 892
Mailing Address - Street 2:
Mailing Address - City:BARRACKVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26559-0892
Mailing Address - Country:US
Mailing Address - Phone:304-296-1731
Mailing Address - Fax:304-225-2288
Practice Address - Street 1:301 SCOTT AVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-8804
Practice Address - Country:US
Practice Address - Phone:304-296-1731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV62446163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse