Individual
EVA JO DITMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CFNP
Contact information
Practice address
107 KOONTZ AVE STE 200, CLENDENIN, WV 25045-9581
(304) 548-7272
Mailing address
104 ALEX LN, CHARLESTON, WV 25304-2952
(304) 734-2040
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
123860
WV
Other
Enumeration date
08/01/2025
Last updated
08/04/2025
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