Jennifer Nicole Rose
Family Doctor
1464 Jefferson St N
Lewisburg
, West Virginia 24901-1380
Jennifer Nicole Rose
Family Doctor
1464 Jefferson St N
Lewisburg
, West Virginia 24901-1380
(844) 479-4545
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About
Features
Specialties
- Family Doctor
Languages spoken
- English
Location
First Address
- Jennifer Nicole Rose
- 1464 Jefferson St N
- Lewisburg, WV
- Zip : 24901-1380
- Fax : (844) 479-4545
- Phone : (304) 645-3220
Second Address
- Jennifer Nicole Rose
- 1464 Jefferson St N
- Lewisburg, WV
- Zip : 24901-1380
- Fax : (844) 479-4545
- Phone : (304) 645-3220
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Q00000X | Family Doctor | 2724 | WV |
National Provider Identifier
| NPI | 1003175993 |
|---|---|
| Provider Name | Jennifer Nicole Rose |
| First Address | Lewisburg, WV 24901-1380 |
| Second Address | Lewisburg, WV 24901-1380 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 11/05/2012 |
| Last Update Date | 24/08/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 3810029042 | (05) | WV |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.