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General NPI Number Information
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NPI Number | 1376994947
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Entity Type | Organization
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Legal Business Name | NP 2U
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Dates
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Enumeration Date | 06/24/2016
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Last Update Date | 06/24/2016
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Provider Practice Location Address
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Address Line | 1491 RADABAUGH RIDGE RD
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City | BUCKHANNON
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State | WV
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Zip | 26201-6901
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Country | US
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Telephone | 304-613-5842
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Fax |
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Provider Business Mailing Address
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Address Line | 1491 RADABAUGH RIDGE RD
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City | BUCKHANNON
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State | WV
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Zip | 26201-6901
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Country | US
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Telephone | 304-613-5842
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Fax |
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Authorized Official
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Title or Position | FNP
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Name | NICOLE RADABAUGH
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Credential | FNP
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Telephone | 304-613-5842
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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 | 59918
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License Number State | WV
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