Provider Demographics
NPI:1689152308
Name:GUNTER, CASSIE LEE (APRN FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:CASSIE
Middle Name:LEE
Last Name:GUNTER
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 ORIOLE LN
Mailing Address - Street 2:
Mailing Address - City:FENWICK
Mailing Address - State:WV
Mailing Address - Zip Code:26202-0904
Mailing Address - Country:US
Mailing Address - Phone:304-846-2856
Mailing Address - Fax:
Practice Address - Street 1:1256 N EISENHOWER DR STE 700
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-3120
Practice Address - Country:US
Practice Address - Phone:304-254-2415
Practice Address - Fax:304-250-0220
Is Sole Proprietor?:No
Enumeration Date:2018-08-03
Last Update Date:2020-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN88845NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily