Individual
MRS. TABITHA D. WAUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
830 PENNSYLVANIA AVE STE 201, CHARLESTON, WV 25302
(304) 388-6950
(304) 388-6955
Mailing address
830 PENNSYLVANIA AVE STE 201, CHARLESTON, WV 25302-3389
(304) 388-6950
(304) 388-6955
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN72242NP
WV
Other
Enumeration date
08/14/2017
Last updated
07/16/2019
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