Individual
KENNETH EARL GWINN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
Mailing address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
107635
WV
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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