Pack, Jennifer L

Pack, Jennifer L is an individual health care provider with primary practice located at 122 12Th St , Princeton WV 24740. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Pack, Jennifer L can be contacted via phone (304) 487-7000.

Contact Information

Primary practice address
122 12Th St Princeton WV 24740
Phone: (304) 487-7000
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 878 West Virginia

Profile Details

NPI number 1396786562
LBN Legal business name Pack, Jennifer L
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Nov 9th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396786562 NPPES
West Virginia Other P00343573 MEDICARE RAILROAD

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