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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

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