Provider Demographics
NPI:1578080925
Name:DUELLEY, CARLYN ASHLEY (FNP)
Entity Type:Individual
Prefix:MRS
First Name:CARLYN
Middle Name:ASHLEY
Last Name:DUELLEY
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 103
Mailing Address - Street 2:
Mailing Address - City:PAW PAW
Mailing Address - State:WV
Mailing Address - Zip Code:25434-0103
Mailing Address - Country:US
Mailing Address - Phone:304-947-7651
Mailing Address - Fax:
Practice Address - Street 1:812 AMHERST ST STE 201
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-3344
Practice Address - Country:US
Practice Address - Phone:540-450-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-26
Last Update Date:2017-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024175126363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily