MEDICARE: MONTANA WAMSLEY N.P.

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
1	363LF0000X	Family Nurse Practitioner	114907	WV

General Provider Information

NPI Number	:	1619683067
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONTANA WAMSLEY N.P.

Provider Business Mailing Address
First Line	:	PO BOX 1680
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25717-1680
Country	:	US
Telephone Number	:	304-781-5151
Fax Number	:

Provider Business Practice Location Address
First Line	:	26489 HUNTINGTON RD
Second Line	:
City	:	APPLE GROVE
State	:	WV
Zip	:	25502-8008
Country	:	US
Telephone Number	:	304-675-5725
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	04/21/2025

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Directions to “ MONTANA WAMSLEY N.P.” Practice Location

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