Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KIESHA MARIE BULLOUGH, PA-C
ActiveKIESHA MARIE BULLOUGH, PA-C is a Physician Assistant healthcare provider located in CLARKSBURG, West Virginia. NPI 1700113412 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · CLARKSBURG, WV
Registration Details
- NPI Number
- 1700113412
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Nov 17, 2009 (16.775172171285 yrs)
- Last Updated
- Jun 17, 2016
- License
-
01444 (WV)
Practice Information
- Address
-
700 OAKMOUND RDCLARKSBURG, WV, 263019398Browse WV providers · Browse ZIP 26301
- Phone
- 3046236330
- Fax
- 3046236220
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in CLARKSBURG, WV
| Name | Credential | NPI |
|---|---|---|
| MRS. LAURA JEAN STAVRAKIS | PAC | 1053390351 |
| MRS. SUSAN LEWIS GIVEN | MPAS, PAC | 1740249481 |
| MS. NANCY S STULL | PA-C | 1346200557 |
| MR. STEPHEN JOSEPH CROMWELL | P.A.-C. | 1699735779 |
| MR. ROBERT G GIVEN JR. | PAC | 1306807524 |
| MR. THOMAS HARRY CHASE | — | 1699739938 |
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.