| NPI | 1114478195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BECKY MINCEY Med Staff Coordinator 304-927-8143 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 75190) |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |