| NPI | 1558743849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSICA HUDSON CFO 304-343-1950 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2015-06-23 |
| Last Update Date | 2021-01-12 |