Individual
LORETTA J WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
70 N STURMER ST, BELINGTON, WV 26250
(304) 823-2800
(304) 823-2703
Mailing address
70 N STURMER ST, BELINGTON, WV 26250-7403
(304) 823-2800
(304) 823-2703
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
37037
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810024896
—
WV
01
—
WV231B
MEDICARE PTAN
WV
Enumeration date
10/18/2012
Last updated
06/28/2018
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