Individual
CASEY M STREET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
RT 20, PINE GROVE, WV 26419-0418
(304) 889-3344
Mailing address
PO BOX 418, PINE GROVE, WV 26419-0418
(304) 889-3344
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
73105
WV
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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