Individual
KRISTEN CASEBOLT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
4825 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1365
(304) 346-9667
Mailing address
1105 PARK AVE, NITRO, WV 25143-1225
(304) 553-1363
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
39736
WV
Other
Enumeration date
06/22/2023
Last updated
06/22/2023
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