Healthcare Provider Details

I. General information

NPI: 1134225444
Provider Name (Legal Business Name): JACQUELINE C. RANSON FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JACQUELINE C. O'NEIL FNP-BC

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 03/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 LYNN AVE
HAMLIN WV
25523-1138
US

IV. Provider business mailing address

1563 SAND PLANT RD
SOUTH CHARLESTON WV
25309-6120
US

V. Phone/Fax

Practice location:
  • Phone: 304-824-5806
  • Fax: 304-824-5804
Mailing address:
  • Phone: 304-756-1500
  • Fax: 304-756-1548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number57338
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: