LISA R MALLORY

SOUTH CHARLESTON, WV
NPI1598223216
Former NameLISA ADKINS
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LA2200X Nurse Practitioner, Adult Health
(Licence: WV  APRN74140-AGPCNP-BC)
Additional Taxonomies363LG0600X Nurse Practitioner, Gerontology
(Licence: WV  APRN741400AGPCNP-BC)
Enumeration Date2019-03-12
Last Update Date2021-01-07
Business Address
LISA R MALLORY AGNP-C
506 CHESTNUT ST
SOUTH CHARLESTON, WV 25309-1204
Phone number: 304-766-8558
Mailing Address
LISA R MALLORY AGNP-C
4605 MACCORKLE AVE SW
SOUTH CHARLESTON, WV 25309-1311
Phone number: 304-414-4800