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NPI Code Detail

MEDICARE: JENNIFER DAWN BEAVER

MEDICARE:   JENNIFER DAWN BEAVER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1376J00000XHomemaker

General Provider Information

NPI Number : 1952906398
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER DAWN BEAVER
Provider Business Mailing Address
First Line : 11 ASHWOOD DR
Second Line :
City : VIENNA
State : WV
Zip : 26105-3309
Country : US
Telephone Number : 304-295-6567
Fax Number : 304-471-2488
Provider Business Practice Location Address
First Line : 1222 MARKET ST
Second Line :
City : PARKERSBURG
State : WV
Zip : 26101-4323
Country : US
Telephone Number : 304-865-5420
Fax Number : 304-865-5423
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2020
Last Update Date : 12/03/2020

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Directions to “ JENNIFER DAWN BEAVER ” Practice Location

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