Healthcare Provider Details

I. General information

NPI: 1366848665
Provider Name (Legal Business Name): ANDREW JOSEPH COURSER MSN, APRN, FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/13/2014
Last Update Date: 01/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SUNCREST TOWN CENTRE DR SUITE 110
MORGANTOWN WV
26505-1872
US

IV. Provider business mailing address

600 SUNCREST TOWN CENTRE DR SUITE 110
MORGANTOWN WV
26505-1872
US

V. Phone/Fax

Practice location:
  • Phone: 304-598-4478
  • Fax: 304-599-0796
Mailing address:
  • Phone: 304-598-4478
  • Fax: 304-599-0796

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN89747-NP-C
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: