Provider Demographics
NPI:1376994947
Name:NP 2U
Entity Type:Organization
Organization Name:NP 2U
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:RADABAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:304-613-5842
Mailing Address - Street 1:1491 RADABAUGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:BUCKHANNON
Mailing Address - State:WV
Mailing Address - Zip Code:26201-6901
Mailing Address - Country:US
Mailing Address - Phone:304-613-5842
Mailing Address - Fax:
Practice Address - Street 1:1491 RADABAUGH RIDGE RD
Practice Address - Street 2:
Practice Address - City:BUCKHANNON
Practice Address - State:WV
Practice Address - Zip Code:26201-6901
Practice Address - Country:US
Practice Address - Phone:304-613-5842
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-24
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV59918363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty