Organization
COAL RIVER PRIMARY CARE AND WELLNESS CENTER LLC
Active
Other names
Coal River Primary
Organization subpart
No
Provider details
NPI number
Authorized official
REBECCA RUBY BARKER FNP (SOLE OWNER; FNP-BC)
(304) 833-0815
Entity
Organization
Contact information
Practice address
62 FORK CREEK RD, NELLIS, WV 25142-9737
(304) 833-0815
(304) 833-0030
Mailing address
62 FORK CREEK RD, NELLIS, WV 25142-9737
(304) 833-0815
(304) 833-0030
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
364SF0001X
Family Health Clinical Nurse Specialist
—
—
Other
Enumeration date
01/18/2020
Last updated
04/05/2022
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