Most Relevant Information
Provider Data
| NPI Number: | 1003528035 |
| Provider Name: | GINA MARIE PELLETTERE |
| Entity Type: | Individual |
| Taxonomy Code: | 164W00000X |
| Specialty: | Licensed Practical Nurse |
| License Number: | 09452 |
Most Important Dates
| Enumeration Date: | 12/21/2022 |
| Last Updated: | 12/21/2022 |
Provider Practice Location
12 ROUSCH DR
MORGANTOWN
WV
265013872
Practice Location Phone/Fax
| Phone: | 3045986099 |
| Fax: | 3049743006 |
Provider Mailing Location
12 ROUSCH DR
MORGANTOWN
WV
265013872
Provider Mailing Phone/Fax
| Phone: | 3045986099 |
| Fax: | 3049743006 |