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Individual

MS. JESSICA DANAE GAWTHROP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN, FNP-BC

Contact information

Practice address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3804
(304) 399-6727
(304) 399-6726
Mailing address
1340 HAL GREER BLVD, HUNTINGTON, WV 25701-3804
(304) 399-6727
(304) 399-6726

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
82935
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0307067
OH
05
1295101186
WV
05
7100549470
KY
Enumeration date
07/18/2018
Last updated
04/13/2021
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