Stephen Upton
Individual provider Active NPI Nurse Practitioner · Leon, WV
NPI 1760808232 · NPPES record last updated Apr 11, 2023
Key facts
- NPI
- 1760808232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN73115-FNP-BC (WV)
- Practice address
- 27353 Charleston Rd
Leon, WV 25123-9209 - Phone
- (304) 812-4548
- NPI assigned
- Mar 8, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN73115-FNP-BC | WV | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN73115-FNP-BC | WV | Yes |
Addresses
Primary practice location
27353 Charleston Rd
Leon, WV 25123-9209
Mailing address
265 Tribble Rd
Leon, WV 25123-9209
Other providers in Leon, WV
All providers in Leon, WV · Nurse Practitioner 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 Apr 11, 2023. 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.