Individual
MARY JANE PHIPPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
202 LARRY JOE HARLESS DR, GILBERT, WV 25621
(304) 664-6270
(304) 664-6272
Mailing address
7400 LYNN AVE, HAMLIN, WV 25523-1138
(304) 824-5806
(304) 824-5804
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
50819
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810021064
—
WV
Enumeration date
09/22/2010
Last updated
03/08/2019
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