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Contact Information

COAL RIVER PRIMARY CARE AND WELLNESS CENTER LLC
62 FORK CREEK RD
NELLIS, WV25142-9737
 Phone: 304-833-0815
 Fax: 304-833-0030
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Family Health

364SF0001X 89 Certified Clinical Nurse Specialist
 

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for COAL RIVER PRIMARY CARE AND WELLNESS CENTER LLC · (Female)

NPI Number 1487284451
Status Active
Credentials
Entity Individual
Enumeration date 01/18/2020
Last updated 04/05/2022 - About 4 years ago
Sole proprietor 1 Not specified
Identifiers Not Available
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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