Healthcare Provider Details

I. General information

NPI: 1366410219
Provider Name (Legal Business Name): RICHARD SCOTT CRISER CFNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 04/18/2022
Certification Date: 04/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 HOSPITAL DR
SPENCER WV
25276-1050
US

IV. Provider business mailing address

200 HOSPITAL DR
SPENCER WV
25276-1050
US

V. Phone/Fax

Practice location:
  • Phone: 304-927-6822
  • Fax: 304-927-6393
Mailing address:
  • Phone: 304-927-6822
  • Fax: 304-927-6393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number49693
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: