MEDICARE: BOBBI KAY DUTCHER FNP BC

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	363L00000X	Nurse Practitioner	APRN.CNP.0030521	OH
2	363LF0000X	Family Nurse Practitioner	111337	WV

General Provider Information

NPI Number	:	1750039996
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOBBI KAY DUTCHER FNP BC

Provider Business Mailing Address
First Line	:	137 N 16TH ST
Second Line	:
City	:	WHEELING
State	:	WV
Zip	:	26003-7072
Country	:	US
Telephone Number	:	304-312-3964
Fax Number	:

Provider Business Practice Location Address
First Line	:	2200 FLORAL ST
Second Line	:
City	:	MOUNDSVILLE
State	:	WV
Zip	:	26041-1293
Country	:	US
Telephone Number	:	304-843-1035
Fax Number	:

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

Provider Enumeration Date	:	03/16/2022
Last Update Date	:	03/23/2022

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