Individual
MS. JESSICA ANN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
107 STAUNTON DR, WESTON, WV 26452-5604
(304) 269-2022
(304) 269-2037
Mailing address
107 STAUNTON DR, WESTON, WV 26452-5604
(304) 269-2022
(304) 269-2037
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
75079
WV
363LP2300X
Primary Care Nurse Practitioner
SP017040
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093251076
—
WV
Enumeration date
01/13/2017
Last updated
08/31/2022
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