Individual
LAURIE A THEEKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1 MEDICAL CENTER DRIVE, MORGANTONW, WV 26506
(304) 598-6900
(304) 598-6914
Mailing address
P. O. BOX 897, MORGANTOWN, WV 26507-0897
(304) 293-7401
(304) 293-6963
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
037148
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0166639000
—
WV
Enumeration date
08/31/2006
Last updated
10/22/2010
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