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Active Organization

Nurse Practitioner · BECKLEY, WV

Registration Details

NPI Number
1417079229
Provider Type
Organization
NPI Issued
Apr 4, 2007 (19.090771263226 yrs)
Last Updated
Sep 11, 2025

Practice Information

Address
269 B STANAFORD RD
BECKLEY, WV, 25802
Browse WV providers · Browse ZIP 25802
Phone
3044655066
Fax
3044655066
Primary Specialty
Nurse Practitioner
363L00000X
Additional Specialty
Pediatrics
Additional Specialty
Nurse Practitioner
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.