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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

LISA R MALLORY, AGNP-C

Active

Adult Health Nurse Practitioner · SOUTH CHARLESTON, WV

Registration Details

NPI Number
1598223216
Provider Type
Individual
Gender
Female
NPI Issued
Mar 12, 2019 (7.1196142266756 yrs)
Last Updated
Jan 7, 2021
Licenses
APRN741400AGPCNP-BC (WV)
APRN74140-AGPCNP-BC (WV)

Practice Information

Address
506 CHESTNUT ST
SOUTH CHARLESTON, WV, 253091204
Browse WV providers · Browse ZIP 25309
Phone
3047668558
Fax
3047668561
Primary Specialty
Adult Health Nurse Practitioner
363LA2200X

Other Adult Health Nurse Practitioner Providers in SOUTH CHARLESTON, WV

Name Credential NPI
NOLAN SANKOFF 1295516250
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.