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Individual

KEISHA R SAUNDERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
RR 103 SUPPLY STREET, GARY, WV 24836-0507
(304) 448-2101
(304) 448-3217
Mailing address
133 HUNDLEY ST, APT. 2, PRINCETON, WV 24740-2489
(304) 320-7595

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71622
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
002725664
HIGHMARK BCBS
WV
05
3810024326
WV
Enumeration date
08/30/2012
Last updated
12/14/2012
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