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NPI Code Detail

MEDICARE: MRS. MARIE BEAUMONT ZWICK CFNP

MEDICARE: MRS. MARIE BEAUMONT ZWICK CFNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner34060WV

General Provider Information

NPI Number : 1144224643
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MARIE BEAUMONT ZWICK CFNP
Provider Business Mailing Address
First Line : 3415 MACCORKLE AVE SE
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-1334
Country : US
Telephone Number : 304-388-1790
Fax Number : 304-388-1795
Provider Business Practice Location Address
First Line : 3415 MACCORKLE AVE SE
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-1334
Country : US
Telephone Number : 304-388-1790
Fax Number : 304-388-1795
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2005
Last Update Date : 02/22/2017

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