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General NPI Number Information
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NPI Number | 1619683067
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Entity Type | Individual
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Provider Name | MONTANA WAMSLEY N.P.
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Gender | Male
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 26489 HUNTINGTON RD
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City | APPLE GROVE
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State | WV
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Zip | 25502-8008
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Country | US
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Telephone | 304-675-5725
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1680
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City | HUNTINGTON
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State | WV
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Zip | 25717-1680
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Country | US
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Telephone | 304-781-5151
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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 | 114907
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License Number State | WV
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