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General NPI Number Information
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NPI Number | 1659706463
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Entity Type | Individual
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Provider Name | EMILY RENAE OBERTANCE FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/11/2013
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Last Update Date | 04/18/2022
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DRIVE
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City | MORGANTOWN
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State | WV
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Zip | 26505
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Country | US
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Telephone | 304-598-4000
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Fax |
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Provider Business Mailing Address
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Address Line | 451 WIRSING RD
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City | GIBBON GLADE
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State | PA
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Zip | 15440-1128
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Country | US
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Telephone | 724-329-0914
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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 | APRN66336-FNP-BC
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License Number State | WV
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