Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | APRN31625-NNP-BC | WV |
NPI | 1043596604 |
---|---|
Provider Name | Betty Gay Dillon |
First Address | Huntington, WV 25701-3800 |
Second Address | Huntington, WV 25701-3800 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/10/2011 |
Last Update Date | 28/06/2017 |