Provider Demographics
NPI:1316457476
Name:MAY, CHARITY LYNN (FNP-BC)
Entity type:Individual
Prefix:
First Name:CHARITY
Middle Name:LYNN
Last Name:MAY
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:CHARITY
Other - Middle Name:LYNN
Other - Last Name:ROGERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 MEDICAL PARK
Mailing Address - Street 2:SUITE 704
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003
Mailing Address - Country:US
Mailing Address - Phone:304-243-3134
Mailing Address - Fax:304-243-3834
Practice Address - Street 1:1 MEDICAL PARK
Practice Address - Street 2:SUITE 704
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003
Practice Address - Country:US
Practice Address - Phone:304-243-3134
Practice Address - Fax:304-243-3834
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-03
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV84985363L00000X
WVAPRN84985363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0247639Medicaid