Most Relevant Information
Provider Data
| NPI Number: | 1003417023 |
| Provider Name: | KENNETH EARL GWINN FNP-C |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 107635 |
Most Important Dates
| Enumeration Date: | 11/05/2020 |
| Last Updated: | 11/05/2020 |
Provider Practice Location
176 MEDICAL CENTER DR
RAINELLE
WV
259621064
Practice Location Phone/Fax
| Phone: | 3044386188 |
| Fax: |
Provider Mailing Location
176 MEDICAL CENTER DR
RAINELLE
WV
259621064
Provider Mailing Phone/Fax
| Phone: | 3044386188 |
| Fax: |