Individual
GLENN CARL SUTPHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
122 12TH ST, PRINCETON, WV 24740-2312
(304) 487-7000
Mailing address
203 UNION DR, PRINCETON, WV 24740-8822
(304) 921-0275
Taxonomy
Speciality
Code
Description
License number
State
163WF0300X
Flight Registered Nurse
81976
WV
363LF0000X
Family Nurse Practitioner
Primary
121399
WV
Other
Enumeration date
11/12/2024
Last updated
12/20/2024
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