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General NPI Number Information
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NPI Number | 1003793845
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Entity Type | Individual
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Provider Name | ANDREW ARLIE FUNK APRN-FNP BC
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Gender | Male
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Dates
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Enumeration Date | 08/20/2025
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Last Update Date | 09/29/2025
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Provider Practice Location Address
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Address Line | 117 HOSPITAL DR
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City | PETERSBURG
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State | WV
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Zip | 26847-9566
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Country | US
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Telephone | 304-257-1026
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Fax |
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Provider Business Mailing Address
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Address Line | 117 HOSPITAL DR
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City | PETERSBURG
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State | WV
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Zip | 26847-9566
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Country | US
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Telephone | 304-257-1026
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Fax | 304-257-1412
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 123781
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License Number State | WV
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