Individual
MANDI JO WILT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSN, APRN, FNP-C
Contact information
Practice address
164 PARKVIEW DR, KEYSER, WV 26726-2313
(304) 597-2494
Mailing address
215 KEYS ST, KEYSER, WV 26726-3619
(304) 790-2033
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
104532
WV
Other
Enumeration date
02/20/2023
Last updated
02/20/2023
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