person
Lisa R Mallory, AGNP-C
Adult Health Nurse Practitioner in South Charleston, West Virginia
NPI 1598223216

Lisa R Mallory is an Adult Health Nurse Practitioner based in South Charleston, WV and is specialized in Adult Health. Lisa R Mallory practices in South Charleston, WV and has the professional credentials of AGNP-C. The NPI Number for Lisa R Mallory is 1598223216 and holds a License No. APRN741400AGPCNP-BC (West Virginia).

The current practice location address for Lisa R Mallory is 506 Chestnut St, South Charleston, WV and can be reached out via phone at 304-766-8558 and via fax at 304-766-8561.

Location: 506 Chestnut St, South Charleston, WV, 25309-1311
person
Provider Profile Details
NPI Number
1598223216
Provider Name
Lisa R Mallory
Credential
AGNP-C
Provider Entity Type
Individual
Gender
Female
Address
506 Chestnut St, South Charleston, WV, 25309-1311
Phone Number
304-766-8558
Fax Number
304-766-8561
Provider Enumeration Date
03/12/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
506 Chestnut St
City
State
Zip
25309-1204
Phone Number
304-766-8558
Fax Number
304-766-8561
person
Provider Business Mailing Address Details
Address
506 Chestnut St
City
State
Zip
25309-1204
Phone Number
304-766-8558
Fax Number
304-766-8561
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Adult Health
Taxonomy
License No.
APRN74140-AGPCNP-BC (West Virginia)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
APRN741400AGPCNP-BC (West Virginia)
Definition
Definition to come...
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