Provider Demographics
NPI:1992150452
Name:BARTOE, SHANNON (APRN, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:SHANNON
Middle Name:
Last Name:BARTOE
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:SHANNON
Other - Middle Name:
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-BC
Mailing Address - Street 1:1600 MEDICAL CENTER DRIVE, SUITE G-500
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25701-3655
Mailing Address - Country:US
Mailing Address - Phone:304-691-1262
Mailing Address - Fax:304-691-1108
Practice Address - Street 1:1600 MEDICAL CENTER DRIVE, SUITE G-500
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-3655
Practice Address - Country:US
Practice Address - Phone:304-691-1262
Practice Address - Fax:304-691-1108
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN61713-FNP-BC363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily