Active NPI
Misty Dillow, FNP
- Family Nurse Practitioner
- Princeton, WV
National Provider Identifier
1972891265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 66614
- Practice address
- 122 12TH Street Ext
Princeton, WV 24740-2352 - Phone
- (304) 487-7000
- NPI assigned
- Jul 20, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 66614 | WV | Primary |
Addresses
Primary practice location
122 12TH Street Ext
Princeton, WV 24740-2352
Mailing address
1431 Centerpoint Blvd
Suite 100
Knoxville, TN 37932-1984
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311120000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1311120000000",
"number": "1972891265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1431 CENTERPOINT BLVD",
"address_2": "SUITE 100",
"city": "KNOXVILLE",
"state": "TN",
"postal_code": "379321984"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 12TH STREET EXT",
"city": "PRINCETON",
"state": "WV",
"postal_code": "247402352",
"telephone_number": "304-487-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILLOW",
"first_name": "MISTY",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-20",
"last_updated": "2011-07-20",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "WV",
"license": "66614",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Princeton, WV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.