Individual
MRS. MARY KATHERINE ELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
6 COURTNEY DR, CHARLESTON, WV 25304-2696
(304) 720-9073
(304) 720-1921
Mailing address
3712 VIRGINIA AVE SE, CHARLESTON, WV 25304-1506
(304) 617-1490
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
52349
WV
Other
Enumeration date
08/05/2013
Last updated
08/05/2013
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