Individual
NANCY BETH LARES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2414 JEFFERSON AVE, PT PLEASANT, WV 25550-1528
(304) 675-1484
(304) 675-1489
Mailing address
1400 HOSPITAL DR, HURRICANE, WV 25526-9202
(304) 675-1484
(304) 675-1489
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
22263
WV
208M00000X
Hospitalist Physician
Primary
22263
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
550737600
TAX IDENTIFICATION
WV
Enumeration date
06/27/2006
Last updated
05/25/2017
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