Healthcare Provider Details

I. General information

NPI: 1083615140
Provider Name (Legal Business Name): VERA ANN BARTON-MAXWELL PH.D, APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 06/10/2024
Certification Date: 06/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 29TH ST
WHEELING WV
26003-4161
US

IV. Provider business mailing address

61 29TH ST
WHEELING WV
26003-4161
US

V. Phone/Fax

Practice location:
  • Phone: 304-233-9323
  • Fax:
Mailing address:
  • Phone: 304-650-0888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0377093 22
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: