Provider Demographics
NPI:1023402476
Name:STOVER, CARI (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:CARI
Middle Name:
Last Name:STOVER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4307 MACCORKLE AVE SE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-2500
Mailing Address - Country:US
Mailing Address - Phone:304-205-6123
Mailing Address - Fax:
Practice Address - Street 1:4307 MACCORKLE AVE SE
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25304-2500
Practice Address - Country:US
Practice Address - Phone:304-205-6123
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN91060-NP-C363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV1023402476Medicaid
WV3810024049OtherMEDICAID-GROUP
B441OtherMEDICARE-GROUP
WV3810024049OtherMEDICAID-GROUP