Individual
JESSICA BOARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
400 MATTHEW ST STE 401, MARIETTA, OH 45750-1656
(740) 374-2252
(740) 374-4974
Mailing address
416 COLEGATE DR BLDG 3, MARIETTA, OH 45750-9549
(740) 568-4814
(740) 374-3165
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
APRN.CNP.019648
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0189541
—
OH
Enumeration date
09/21/2016
Last updated
12/15/2021
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