IndividualActive
Kristine Agnew, P.A.C.
NPI 1639100266 · Surgical Physician Assistant · South Charleston, WV
Provider details
- NPI number
- 1639100266
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- P.A.C.
- Sex
- Female
- Sole proprietor
- No
- License
- 412 (WV)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
4607 Maccorkle Ave Sw Ste 206
South Charleston, WV 25309-1364
Phone: (304) 766-1133
Fax: (304) 766-1136
Approximate (ZIP-level) locationGet directions
Mailing address
4605 Maccorkle Ave Sw
South Charleston, WV 25309-1311
Registry dates
- Enumerated
- 2006-07-05
- Last updated
- 2021-08-18
- Certified
- 2021-08-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.