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Organization
TRI-STATE FAMILY MEDICINE & BEHAVIORAL HEALTH, LLC
Active
Organization
TRI-STATE FAMILY MEDICINE & BEHAVIORAL HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARMEN SIGLEY (APRN)
(304) 777-9039
Entity
Organization
Contact information
Practice address
17833 FAIR LADY WAY, DARNESTOWN, MD 20874-2289
(304) 777-9039
Mailing address
17833 FAIR LADY WAY, DARNESTOWN, MD 20874-2289
(304) 777-9039
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
363L00000X
Nurse Practitioner
Primary
R208314
MD
363LF0000X
Family Nurse Practitioner
76278
WV
Other
Enumeration date
05/02/2017
Last updated
02/02/2021
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