Provider Demographics
NPI:1174135388
Name:CHARLES, SHARI DENISE
Entity type:Individual
Prefix:
First Name:SHARI
Middle Name:DENISE
Last Name:CHARLES
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 1:2084 COAL CITY RD
Mailing Address - Street 2:
Mailing Address - City:COAL CITY
Mailing Address - State:WV
Mailing Address - Zip Code:25823-9615
Mailing Address - Country:US
Mailing Address - Phone:304-673-1255
Mailing Address - Fax:
Practice Address - Street 1:2084 COAL CITY RD
Practice Address - Street 2:
Practice Address - City:COAL CITY
Practice Address - State:WV
Practice Address - Zip Code:25823-9615
Practice Address - Country:US
Practice Address - Phone:304-673-1255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-19
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant