Individual
MARY ELLEN WIMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
314 PINE STREET, FRANKLIN, WV 26807-0100
(304) 358-2355
(304) 358-3054
Mailing address
PO BOX 100, 314 PINE STREET, FRANKLIN, WV 26807-0100
(304) 358-2355
(304) 358-3054
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
39542
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002000637
MS BCBS
WV
05
—
3810009958
—
WV
Enumeration date
07/30/2007
Last updated
07/09/2010
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