| NPI | 1356873558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE SELENA MILLER Nurse Practitioner 304-530-5980 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WV 58804) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2024-01-19 |