Individual
MRS. JERRA LEIGH SHUFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
645 KANAWHA AVE, RAINELLE, WV 25962-1013
(304) 438-6188
(304) 438-6819
Mailing address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
(304) 438-6819
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
61894
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810023074
—
WV
Enumeration date
02/10/2012
Last updated
09/30/2021
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