Individual
MRS. REBECCA WILES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
99 TAVERN RD, MARTINSBURG, WV 25401-2890
(304) 263-4999
Mailing address
PO BOX 1146, MARTINSBURG, WV 25402-1146
(304) 263-4999
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R209468
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F08191349
AANP
MD
Enumeration date
09/07/2019
Last updated
01/26/2023
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