Individual
GINA OFCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
800 GRAND CENTRAL MALL STE 4, VIENNA, WV 26105-4100
(304) 485-3300
Mailing address
800 GRAND CENTRAL MALL STE 4, VIENNA, WV 26105-4100
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN50626NP
WV
Other
Enumeration date
07/27/2017
Last updated
10/01/2025
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