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Individual

ANITA KAYVON WIPPEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
501 STATE ST, PROCTORVILLE, OH 45669-3015
(740) 886-2674
(740) 886-2675
Mailing address
501 STATE ST, PROCTORVILLE, OH 45669-3015
(740) 886-2674
(740) 886-2675

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN282306
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2256348
OH
05
7105046000
WV
Enumeration date
10/02/2006
Last updated
02/07/2013
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