Momen, Jennifer Jill

Momen, Jennifer Jill is an individual health care provider with primary practice located at 11 Chenoweth Drive Suite A, Bridgeport WV 26330. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Momen, Jennifer Jill can be contacted via phone (303) 842-5777.

Contact Information

Primary practice address
11 Chenoweth Drive Suite A Bridgeport WV 26330
Phone: (303) 842-5777
Fax: (304) 842-3318
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X WV18808 West Virginia

Profile Details

NPI number 1023127818
LBN Legal business name Momen, Jennifer Jill
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Jul 8th, 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 1023127818 NPPES
West Virginia MEDICAID 0110704000

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