| Doctor Name: | SHELLIE FAULSTICK |
| NPI Number: | 1740648609 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 66704 |
| Business Practice Address: | 214 Middle Grave Creek Rd Moundsville, WV - 260416009 |
| Business Phone Number: | 3042313820 |
| Business Fax Number: | |
| Mailing Address: | 30 G C And P Rd, Resa-6 WHEELING |
| State: | WV |
| Postal Code: | 260036129 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/08/2016 |
| NPI Last Update Date: | 02/08/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WS0200X |
| License Number: | 66704 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WV |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | School |
| Taxonomy Definition: | |