Individual
NICOLE R OURS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
422 S MAIN ST, MOOREFIELD, WV 26836-1238
(304) 538-2331
Mailing address
PO BOX 97, BAKER, WV 26801-0097
(803) 435-5270
(304) 897-5915
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2732
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2732
LICENSE
WV
01
—
36745
LICENSE
SC
Enumeration date
07/05/2011
Last updated
02/11/2025
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