Individual
MS. JENNIFER LYNN THAYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
107 KOONTZ AVE STE 200, CLENDENIN, WV 25045-9581
(304) 548-7272
(304) 548-7149
Mailing address
104 ALEX LN, CHARLESTON, WV 25304-2952
(304) 734-2040
(304) 734-2047
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
01691
WV
Other
Enumeration date
10/14/2012
Last updated
10/18/2023
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