Provider Demographics
NPI:1134715642
Name:STOOTS, PATSY EUGENIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:PATSY
Middle Name:EUGENIE
Last Name:STOOTS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:PATSY
Other - Middle Name:EUGENIE
Other - Last Name:ASHCRAFT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:171 SNUFFER BR
Mailing Address - Street 2:
Mailing Address - City:BECKLEY
Mailing Address - State:WV
Mailing Address - Zip Code:25801-9165
Mailing Address - Country:US
Mailing Address - Phone:304-237-4919
Mailing Address - Fax:
Practice Address - Street 1:20 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3452
Practice Address - Country:US
Practice Address - Phone:304-831-1101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-18
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV107983363L00000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner