Provider Demographics
NPI:1659706463
Name:OBERTANCE, EMILY RENAE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:RENAE
Last Name:OBERTANCE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 WIRSING RD
Mailing Address - Street 2:
Mailing Address - City:GIBBON GLADE
Mailing Address - State:PA
Mailing Address - Zip Code:15440-1128
Mailing Address - Country:US
Mailing Address - Phone:724-329-0914
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL CENTER DRIVE
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505
Practice Address - Country:US
Practice Address - Phone:304-598-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-11
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN66336-FNP-BC363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily