# SUMMERSVILLE SKIN CARE CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346316395
- **Authorized official:** DELORES A LUCKY RNC-FNP (NURSE PRACTITIONER)
- **Authorized official phone:** (304) 872-3654

## Contact information

- **Practice address:** 818 ARBUCKLE RD, SUMMERSVILLE, WV 26651-1704
- **Practice address phone:** (304) 872-3654
- **Mailing address:** 818 ARBUCKLE RD, SUMMERSVILLE, WV 26651-1704
- **Mailing address phone:** (304) 872-3654

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | 44396 | WV | Yes |

## Other

- **Enumeration date:** 11/28/2006
- **Last updated:** 07/21/2011