Healthcare Provider Details

I. General information

NPI: 1699109058
Provider Name (Legal Business Name): MARY M. FEURY FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2013
Last Update Date: 04/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 OLD SCHOOLHOUSE ROAD
FOREST HILL WV
24935
US

IV. Provider business mailing address

226 MARKET ST
NEW CASTLE VA
24127-6080
US

V. Phone/Fax

Practice location:
  • Phone: 304-466-1152
  • Fax:
Mailing address:
  • Phone: 304-772-3064
  • Fax: 304-772-3296

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number32509
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number108/2506
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: