Most Relevant Information
Provider Data
| NPI Number: | 1003203316 |
| Provider Name: | NICOLE RADABAUGH FNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN59918-NP-C |
Most Important Dates
| Enumeration Date: | 04/24/2015 |
| Last Updated: | 02/23/2021 |
Provider Practice Location
300 MINUTEMAN DR
WESTON
WV
264522200
Practice Location Phone/Fax
| Phone: | 3049997870 |
| Fax: | 3042690165 |
Provider Mailing Location
10003 WEBSTER RD
CAMDEN ON GAULEY
WV
262087713
Provider Mailing Phone/Fax
| Phone: | 3042265725 |
| Fax: | 3042263274 |