Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHANE WRISTON, PA-C
ActiveSHANE WRISTON, PA-C is a Medical Physician Assistant healthcare provider located in IVYDALE, West Virginia. NPI 1609277201 is currently active in the NPPES registry. Verify at CMS.
Medical Physician Assistant · IVYDALE, WV
Registration Details
- NPI Number
- 1609277201
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 15, 2014 (11.93095230942 yrs)
- Last Updated
- Aug 31, 2022
- License
-
01845 (WV)
Practice Information
- Address
-
797 CLINIC DRIVYDALE, WV, 251138263Browse WV providers · Browse ZIP 25113
- Phone
- 3042864200
- Fax
- 3042862107
- Primary Specialty
-
Medical Physician Assistant
363AM0700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.