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Individual

DR. JEANNINE H POWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD, CGP

Contact information

Practice address
1048 WHITE AVE, MORGANTOWN, WV 26501-6268
(304) 216-6772
Mailing address
1048 WHITE AVE, MORGANTOWN, WV 26501-6268
(304) 216-6772

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0005626
WV
1835G0303X
Geriatric Pharmacist
RP0005626
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RP0005626
WV BOARD OF PHARMACY
WV
Enumeration date
11/22/2006
Last updated
01/29/2020
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