Individual
JENNIFER L. MIDKIFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001163
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000216606
OH MEDICAID UNISON
OH
01
—
000000217253
ANTHEM BCBS
—
01
—
000646536
MOUNTAIN STATE BCBS
—
05
—
0157388000
—
WV
05
—
2229010
—
OH
01
—
650019721
RR MEDICARE
—
Enumeration date
07/14/2006
Last updated
10/24/2011
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