Individual
CARLA DIANE RAYNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
30 MALLARD CT, BECKLEY, WV 25801-3664
(304) 255-0800
Mailing address
30 MALLARD CT, BECKLEY, WV 25801-3664
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN63208-FNP-BC
WV
Other
Enumeration date
07/13/2017
Last updated
07/13/2017
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