Individual
JODI SILVA-DUTEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
402 C STREET, CEREDO, WV 25507
(304) 908-1204
(304) 908-1224
Mailing address
PO BOX 4100, BARBOURSVILLE, WV 25504-4100
(304) 908-1204
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
104196
WV
363LF0000X
Family Nurse Practitioner
APRN.CNP.024952
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN.CNP.024952
APRN
OH
Enumeration date
10/09/2019
Last updated
04/22/2021
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