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General NPI Number Information
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NPI Number | 1790585354
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Entity Type | Individual
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Provider Name | AMANDA KAY WILEY RN
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Gender | Female
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Dates
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Enumeration Date | 03/13/2025
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 300 CORPORATE CENTER DRIVE ATTN: CARDIOLOGY
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City | SCOTT DEPOT
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State | WV
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Zip | 25560
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Country | US
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Telephone | 304-691-6732
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Fax | 304-691-6919
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Provider Business Mailing Address
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Address Line | 107 STONEBROOK DR
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City | HURRICANE
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State | WV
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Zip | 25526-8822
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Country | US
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Telephone | 304-972-3141
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 121532
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License Number State | WV
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