Provider Demographics
NPI:1043017387
Name:PIATT, SHANNAN S (RN)
Entity type:Individual
Prefix:
First Name:SHANNAN
Middle Name:S
Last Name:PIATT
Suffix:
Gender:
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 VIRGINIA ST E STE 400
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25301-2835
Mailing Address - Country:US
Mailing Address - Phone:681-313-4759
Mailing Address - Fax:
Practice Address - Street 1:604 WINGS KNOB PL # A
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-9031
Practice Address - Country:US
Practice Address - Phone:301-938-1519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV91213163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse