Individual
MRS. MARY ELLEN PAULEY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3200 MACCORKLE AVE SE, CAMC VASCULAR CENTER MEMORIAL HOSPITAL, CHARLESTON, WV 25304-1227
(304) 388-8100
(304) 388-8195
Mailing address
7 JAMESTOWN RD, CHARLESTON, WV 25314-1975
(304) 345-8858
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
34219
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0167112000
—
WV
Enumeration date
04/28/2006
Last updated
07/08/2007
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