Individual
KELLI CANTERBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
701 MADISON AVE, MADISON, WV 25130-1669
(304) 369-1230
Mailing address
701 MADISON AVE, MADISON, WV 25130-1669
(304) 369-1230
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
77928
WV
Other
Enumeration date
08/12/2014
Last updated
08/12/2014
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