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Nancy Jean Wolverton
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NPI Number Detailed Information
Provider Information:
| Name: | Nancy Jean Wolverton |
| Gender: | F |
| Provider License Number If Given: | RN1502412 |
NPI Information:
| NPI: | 1710971213 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 8/1/2012 |
Provider Business Mailing Address:
| Address: | 118 12TH STREET Princeton, WV 24740 |
| Phone Number: | 3044315153 |
| Fax Number: | 3044877835 |
Provider Business Practice Location Address:
| Address: | 1333 SOUTHVIEW DR Bluefield, WV 24701 |
| Phone Number: | 3043279205 |
| Fax Number: | 3043279210 |
Provider Taxonomy:
| Primary: | 363L00000X |
| Secondary (if any): | |
| State: | WV |
