Davis, Jessica R

Davis, Jessica R is an sole proprietor health care provider with primary practice located at 202 Maplewood Ave , Ronceverte WV 24970-1334. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Davis, Jessica R can be contacted via phone (304) 647-4411.

Contact Information

Primary practice address
202 Maplewood Ave Ronceverte WV 24970-1334
Phone: (304) 647-4411
Fax: (304) 647-6552
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X 60285 West Virginia

Profile Details

NPI number 1093092033
LBN Legal business name Davis, Jessica R
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 4th, 2011
Last updated Dec 15th, 2011 - about 13 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 1093092033 NPPES
Virginia MEDICAID 1093092033
Virginia MEDICAID 3810021661

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