Individual
DESIRAE ANN TEMPLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, PA-C
Contact information
Practice address
725 N PIKE ST, GRAFTON, WV 26354-1270
(304) 265-4909
(304) 265-4915
Mailing address
PO BOX 35, NEWBURG, WV 26410-0035
(304) 892-2828
(304) 892-2927
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
01234
WV
363AM0700X
Medical Physician Assistant
Primary
394
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810025036
—
WV
Enumeration date
07/27/2007
Last updated
05/03/2016
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