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Individual

MRS. TERESA DIANN HINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-BC

Contact information

Practice address
100 PIN OAK LN, KEYSER, WV 26726-5908
(304) 359-3500
Mailing address
192 CARROLL AVE, KEYSER, WV 26726-5021
(304) 359-5627

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
106873
WV
208M00000X
Hospitalist Physician
106873
WV
363LF0000X
Family Nurse Practitioner
Primary
106873
WV

Other

Enumeration date
01/12/2021
Last updated
04/07/2022
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