Individual
AMANDA M NICOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1 MEDICAL CENTER DRIVE, MORGANTOWN, WV 26506
(304) 598-4800
(304) 598-6873
Mailing address
PO BOX 780, MORGANTOWN, WV 26507-0780
(304) 285-7101
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
63245
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810010886
—
WV
Enumeration date
12/27/2007
Last updated
02/27/2012
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