Individual
LISA QUEEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
497 MALL RD, OAK HILL, WV 25901-6216
(304) 469-2905
Mailing address
497 MALL RD, OAK HILL, WV 25901-6216
(304) 469-2905
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
49029
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001984820
BLUE CROSS BLUE SHIELD
WV
01
—
1071586
WV DWC
WV
05
—
3810021657
—
WV
Enumeration date
04/26/2007
Last updated
01/23/2026
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