Kelli Jo Hupp, FNP-C | |
5722 Cabin Creek Rd, Dawes, WV 25054-7700 | |
(304) 595-5006 | |
(304) 595-5007 |
Full Name | Kelli Jo Hupp |
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Gender | Female |
Speciality | Nurse Practitioner - Family |
Location | 5722 Cabin Creek Rd, Dawes, West Virginia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1073255287 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | 112500 (West Virginia) | Primary |
Entity Name | Cabin Creek Health Center Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366495525 PECOS PAC ID: 2466431101 Enrollment ID: O20130905000096 |
Mailing Address | Practice Location Address |
---|---|
Kelli Jo Hupp, FNP-C 104 Alex Ln, Charleston, WV 25304-2952 Ph: (304) 734-2040 | Kelli Jo Hupp, FNP-C 5722 Cabin Creek Rd, Dawes, WV 25054-7700 Ph: (304) 595-5006 |
Alexandra Ritchie, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5722 Cabin Creek Rd, Dawes, WV 25054 Phone: 304-595-5006 | |
Lily Eliza Smith, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5722 Cabin Creek Rd, Dawes, WV 25054 Phone: 304-595-5006 | |
Byron Menking Hoggatt, RN, CFNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5722 Cabin Creek Road, Dawes, WV 25054 Phone: 304-595-5006 Fax: 304-595-5007 | |
Tiffany Hughes, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 5722 Cabin Creek Road, Dawes, WV 25054 Phone: 304-595-5006 Fax: 304-595-5007 |