Healthcare Provider Details

I. General information

NPI: 1457932329
Provider Name (Legal Business Name): JAMARCUS A HERSHBERGER APRN, BC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2021
Last Update Date: 09/23/2026
Certification Date: 05/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207D COLEGATE DR
MARIETTA OH
45750-2363
US

IV. Provider business mailing address

936 MARKET STREET
PARKERSBURG WV
26101-4737
US

V. Phone/Fax

Practice location:
  • Phone: 740-376-0930
  • Fax: 740-376-0933
Mailing address:
  • Phone: 304-422-7300
  • Fax: 304-428-3719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAPRN.CNP.0031316
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN.456239
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: