Provider Demographics
NPI:1053592196
Name:VELTRI, MARY FRANCES (RN, BSN, CDE, RNFA)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:FRANCES
Last Name:VELTRI
Suffix:
Gender:F
Credentials:RN, BSN, CDE, RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1680
Mailing Address - Street 2:
Mailing Address - City:CLARKSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:26302-1680
Mailing Address - Country:US
Mailing Address - Phone:304-624-2121
Mailing Address - Fax:304-624-1918
Practice Address - Street 1:3 HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:CLARKSBURG
Practice Address - State:WV
Practice Address - Zip Code:26301-9316
Practice Address - Country:US
Practice Address - Phone:304-624-2121
Practice Address - Fax:304-624-1918
Is Sole Proprietor?:No
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV23703163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3810008579Medicaid