Individual
MARY ELLEN SIZEMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
3501 MACCORKLE AVE SE, SE#151, CHARLESTON, WV 25304-1419
(304) 964-6370
(855) 632-8329
Mailing address
140 WHITTINGTON PKWY, SUITE 100, LOUISVILLE, KY 40222-4930
(502) 327-9100
(855) 632-8329
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
52805
WV
363LF0000X
Family Nurse Practitioner
52805
WV
363LF0000X
Family Nurse Practitioner
Primary
APRN52805-FNP-BC
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810010313
—
WV
Enumeration date
08/28/2007
Last updated
12/08/2015
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