Jack, Patricia

Jack, Patricia is an individual health care provider with primary practice located at 87 Swierkos Dr , Moundsville WV 26041-4209. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Jack, Patricia can be contacted via phone (304) 843-2306.

Contact Information

Primary practice address
87 Swierkos Dr Moundsville WV 26041-4209
Phone: (304) 843-2306
Fax: (304) 843-2308
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X West Virginia

Profile Details

NPI number 1801404306
LBN Legal business name Jack, Patricia
Credentials Registered Nurse (RN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2020
Last updated Jul 21st, 2020 - about 4 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 1801404306 NPPES
West Virginia MEDICAID 1821206228
West Virginia MEDICAID 1255523494
West Virginia MEDICAID 1356607394
West Virginia MEDICAID 1710243753
West Virginia MEDICAID 1114118973

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