Wiley, Nicole
Wiley, Nicole is an individual health care provider with primary practice located at 401 Division St Suite 205, South Charleston WV 25309. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Wiley, Nicole can be contacted via phone (304) 414-4875.Contact Information
Primary practice address
401 Division St Suite 205
South Charleston WV 25309
Phone: (304) 414-4875
Fax: (304) 414-4876
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2204 | West Virginia |
Profile Details
| NPI number | 1780800110 |
|---|---|
| LBN Legal business name | Wiley, Nicole |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 17th, 2007 |
| Last updated | Jun 27th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1780800110 | NPPES |
| West Virginia | Other | B441 | MEDICARE GROUP NUMBER |
| West Virginia | Other | 3810008840 | MEDICARE GROUP NUMBER |
| West Virginia | MEDICAID | 3811012117 | MEDICARE GROUP NUMBER |
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