Individual
MICHELLE E HUMPHREYS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
830 PENNSYLVANIA AVE, SUITE 304, CHARLESTON, WV 25302
(304) 388-1515
(304) 388-1570
Mailing address
PO BOX 7000, MORGANTOWN, WV 26507-7000
(304) 347-1290
(304) 347-1397
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
41918
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810003794
—
WV
Enumeration date
09/22/2006
Last updated
07/08/2007
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