Individual
FONDA DEEANN HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
(304) 438-6819
Mailing address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
63171
WV
Other
Enumeration date
10/15/2012
Last updated
01/17/2019
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