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General NPI Number Information
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NPI Number | 1265797724
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Entity Type | Individual
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Provider Name | KRISTIN R YOUTHER FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/11/2012
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Last Update Date | 02/05/2025
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Provider Practice Location Address
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Address Line | 702 STAFFORD DR
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City | PRINCETON
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State | WV
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Zip | 24740-2406
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Country | US
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Telephone | 304-425-0085
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Fax | 304-487-6993
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Provider Business Mailing Address
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Address Line | 702 STAFFORD DR
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City | PRINCETON
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State | WV
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Zip | 24740-2406
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Country | US
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Telephone | 304-425-0085
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Fax | 304-487-6993
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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 | 58892
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License Number State | WV
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