Individual
REBECCA FOUTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3415 MACCORKLE AVE SE, SUITE 100, CHARLESTON, WV 25304
(304) 388-1794
Mailing address
3415 MACCORKLE AVE SE STE 100, CHARLESTON, WV 25304-1334
(304) 388-1794
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
103304
WV
Other
Enumeration date
08/15/2025
Last updated
08/15/2025
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