Individual
AMY WILDASIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
1 MEDICAL CENTER DRIVE, PHYSICIANS OFFICE CENTER, 4TH FLOOR, MORGANTOWN, WV 26506
(304) 598-4890
Mailing address
1 MEDICAL CENTER DRIVE, PO BOX 9238, MORGANTOWN, WV 26506
(304) 293-2706
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN71210-FNP-BC
WV
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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