Provider Demographics
NPI:1760639629
Name:RAMSEY, NICOLE LYNN (LMT)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:LYNN
Last Name:RAMSEY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25303-1510
Mailing Address - Country:US
Mailing Address - Phone:304-414-3629
Mailing Address - Fax:304-414-3633
Practice Address - Street 1:24 DOGWOOD CREEK LANE
Practice Address - Street 2:
Practice Address - City:HICO
Practice Address - State:WV
Practice Address - Zip Code:25854
Practice Address - Country:US
Practice Address - Phone:304-741-4711
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2014-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV001716225200000X
WV2008-2421225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist