| NPI | 1902691272 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLISON HENNESSEY Authorized Official 304-276-9254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2025-04-09 |
| Last Update Date | 2025-04-09 |