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Individual

KATHY DALTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
20 HOSPITAL DR, LOGAN, WV 25601-3452
(304) 831-1188
Mailing address
PO BOX 634760, CINCINNATI, OH 45263-0001
(888) 203-1274

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
2004000260
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810004598
WV
01
P00294309
RAILROAD MEDICARE
WV
Enumeration date
09/14/2006
Last updated
01/25/2008
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