Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 60232 | WV |
NPI | 1013203058 |
---|---|
Provider Name | Mrs. Jennifer Elizabeth Poff |
First Address | Hazard, KY 41701-9529 |
Second Address | Beckley, WV 25801-3140 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2011 |
Last Update Date | 21/02/2017 |