Individual
KELLY BETH HUGHART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
24 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303-1476
(304) 720-5000
(304) 720-5003
Mailing address
24 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25303-1476
(304) 720-5000
(304) 720-5003
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
110561
WV
Other
Enumeration date
10/01/2021
Last updated
10/01/2021
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