Healthcare Provider Details

I. General information

NPI: 1205791829
Provider Name (Legal Business Name): FULL CIRCLE WELLNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

116 DEMPSEY ST
FAYETTEVILLE WV
25840-1353
US

IV. Provider business mailing address

116 DEMPSEY ST
FAYETTEVILLE WV
25840-1353
US

V. Phone/Fax

Practice location:
  • Phone: 304-246-2476
  • Fax: 681-661-0269
Mailing address:
  • Phone: 304-246-2476
  • Fax: 681-661-0269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KRISTEN SISLER
Title or Position: APRN,FNP-BC,PMHNP-BC
Credential: FNP
Phone: 304-246-2476