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Organization
GRACEFULLY RENEWED
Active
Organization
GRACEFULLY RENEWED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHASSITY R KIRK APRN,FNP-BC (NURSE PRACTITIONER)
(304) 305-3662
Entity
Organization
Contact information
Practice address
74 ALFORD BR, HARTS, WV 25524-8700
(304) 305-3662
Mailing address
74 ALFORD BR, HARTS, WV 25524-8700
(304) 305-3662
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/16/2026
Last updated
09/16/2026
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