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General NPI Number Information
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NPI Number | 1326201179
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Entity Type | Individual
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Provider Name | MELANIE D. SOULE NP
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Gender | Female
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 06/28/2016
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Provider Practice Location Address
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Address Line | 16 STERLING DR SUITE 203
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City | BRIDGEPORT
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State | WV
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Zip | 26330-9132
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Country | US
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Telephone | 304-326-2320
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Fax | 304-326-2323
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Provider Business Mailing Address
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Address Line | PO BOX 1610
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City | CLARKSBURG
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State | WV
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Zip | 26302-1610
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Country | US
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Telephone | 304-326-2320
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Fax | 304-326-2323
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 42870
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License Number State | WV
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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 | 2582
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License Number State | SC
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