Organization · Type 2 NPI
Phoenix Rising Healthcare
Primary Care Nurse Practitioner · Fairmont, WV
NPI number
1093284937
Active
Practice location
5 Erwin Ln Ste A
Fairmont, WV 26554-1376
Fax (304) 366-2099
Mailing address
PO Box 1286
Fairmont, WV 26555-1286
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Primary Care Nurse Practitioner Primary | 363LP2300X | None listed |
Primary Care Nurse Practitioner: Definition to come...
Another provider at this address
About NPI 1093284937
Phoenix Rising Healthcare's National Provider Identifier is 1093284937, issued on Nov 21, 2018. The primary taxonomy on file is Primary Care Nurse Practitioner (363LP2300X), and the practice location is in Fairmont, WV. The record was last updated on Oct 15, 2020.