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General NPI Number Information
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NPI Number | 1205517646
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Entity Type | Individual
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Provider Name | KRISTEN ROSE YURETICH APRN
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Gender | Female
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Dates
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Enumeration Date | 07/28/2023
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR
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City | MORGANTOWN
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State | WV
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Zip | 26506-1200
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Country | US
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Telephone | 855-988-2273
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Fax |
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Provider Business Mailing Address
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Address Line | 709 CIRCLE DR
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City | ELIZABETH
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State | PA
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Zip | 15037-2333
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Country | US
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Telephone | 412-721-2518
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Fax |
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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 | SP027853
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 110940
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License Number State | WV
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