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SHIRLEY ELAINE REPASS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
124 BROOKSIDE LANE, BECKLEY, WV 25801
(304) 255-9205
Mailing address
PO BOX 634690, CINCINNATI, OH 45263-0001

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
32835
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3810003760
WV
01
P00335546
RAILROAD MEDICARE
WV
Enumeration date
06/14/2006
Last updated
11/29/2007
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