Provider Demographics
NPI:1285475822
Name:MCCARTY, SHELIA RENAE
Entity type:Individual
Prefix:
First Name:SHELIA
Middle Name:RENAE
Last Name:MCCARTY
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 1:701 BAILEY ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOPE
Mailing Address - State:WV
Mailing Address - Zip Code:25880-1301
Mailing Address - Country:US
Mailing Address - Phone:304-890-0285
Mailing Address - Fax:
Practice Address - Street 1:701 BAILEY ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOPE
Practice Address - State:WV
Practice Address - Zip Code:25880-1301
Practice Address - Country:US
Practice Address - Phone:304-890-0285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant