Provider Demographics
NPI:1396227112
Name:APPALACHIAN MOUNTAIN OF HOPE, INC.
Entity type:Organization
Organization Name:APPALACHIAN MOUNTAIN OF HOPE, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:WHNP-BC/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMRA
Authorized Official - Middle Name:
Authorized Official - Last Name:HANSFORD
Authorized Official - Suffix:
Authorized Official - Credentials:CRNP
Authorized Official - Phone:304-726-4253
Mailing Address - Street 1:41 HUNT CLUB PLAZA
Mailing Address - Street 2:
Mailing Address - City:RIDGELEY
Mailing Address - State:WV
Mailing Address - Zip Code:26753
Mailing Address - Country:US
Mailing Address - Phone:304-726-4253
Mailing Address - Fax:304-726-4187
Practice Address - Street 1:41 HUNT CLUB PLAZA
Practice Address - Street 2:
Practice Address - City:RIDGELEY
Practice Address - State:WV
Practice Address - Zip Code:26753
Practice Address - Country:US
Practice Address - Phone:304-726-4253
Practice Address - Fax:304-726-4187
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APPALACHIAN MOUNTAIN OF HOPE, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV47950363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & GynecologyGroup - Single Specialty