Healthcare Provider Details

I. General information

NPI: 1013347392
Provider Name (Legal Business Name): VIRGINIA HULL PA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/22/2013
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 STAFFORD DR
PRINCETON WV
24740-2405
US

IV. Provider business mailing address

900 STAFFORD DR
PRINCETON WV
24740-2405
US

V. Phone/Fax

Practice location:
  • Phone: 304-431-2600
  • Fax:
Mailing address:
  • Phone: 304-320-4760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110004423
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: