Healthcare Provider Details

I. General information

NPI: 1205209475
Provider Name (Legal Business Name): BRIA HULL FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2015
Last Update Date: 11/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1907 ANN ST
PARKERSBURG WV
26101-2504
US

IV. Provider business mailing address

111 CIRCLE DR
BUCKHANNON WV
26201-3500
US

V. Phone/Fax

Practice location:
  • Phone: 681-315-3100
  • Fax: 681-315-3104
Mailing address:
  • Phone: 304-940-2802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number78141
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: