Stacy Dawn Allport-Pridemore, FNP BC
Nurse Practitioner in South Charleston, WV. Individual provider (NPI-1).
NPI number1649872425
StatusActive
Last updated in NPPESNov 19, 2020
Details
- NPI
- 1649872425
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Stacy Dawn Allport-Pridemore
- Credential
- FNP BC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Nov 16, 2020
- Certification date
- Nov 19, 2020
- Last updated
- Nov 19, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363L00000X | Nurse Practitioner | 107640 | WV | Yes |
Other names
- Stacy Dawn Allport (Former Name)
Practice location
332 6th AveSouth Charleston, WV 25303-1246
Phone 304-343-1950 · Fax 866-225-4179
Mailing address
332 6th AveSouth Charleston, WV 25303-1246
Phone 304-343-1950 · Fax 866-225-4179
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All 10 Nurse Practitioner providers in South Charleston · All 2,788 providers in South Charleston
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