Basic Information
Provider Information
NPI: 1760050181
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEST
FirstName: MARTINA
MiddleName: E
NamePrefix:  
NameSuffix:  
Credential: NP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 220 CAMPUS BLVD STE 100
Address2:  
City: WINCHESTER
State: VA
PostalCode: 226012896
CountryCode: US
TelephoneNumber: 5405365100
FaxNumber:  
Practice Location
Address1: 116 E 3RD AVE
Address2:  
City: RANSON
State: WV
PostalCode: 254381641
CountryCode: US
TelephoneNumber: 3047247200
FaxNumber: 3047247208
Other Information
ProviderEnumerationDate: 06/13/2021
LastUpdateDate: 09/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 09/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP023809PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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