Paul Richard Nuedling, PRSS
Individual provider Active NPI Peer Specialist · Aurora, WV
NPI 1043057664 · NPPES record last updated Jul 10, 2024
Key facts
- NPI
- 1043057664
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Peer Specialist 175T00000X
- License
- 239132 (WV)
- Practice address
- 25208 George Washington Hwy
Aurora, WV 26705-8036 - Phone
- (304) 239-1214
- NPI assigned
- Jul 10, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 239132 | WV | MD | Peer Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jacob'S Ladder at Brookside Farm, LLC | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Peer Specialist | 175T00000X | 239132 | WV | Yes |
Addresses
Primary practice location
25208 George Washington Hwy
Aurora, WV 26705-8036
Mailing address
25208 George Washington Hwy
Aurora, WV 26705-8036
Phone (304) 239-1214
Other providers in Aurora, WV
- Victoria Elizabeth Humphrey
- Jacob'S Ladder at Brookside Farm, LLC
- Bethany Kowalkoski
- Jordan Luzier
- Annette M Moats
- Preston Quigley
- Lee Romine
- Annie Stemple
- Union Ambulance Service Inc
All providers in Aurora, WV · Peer Specialist in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 10, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.