Healthcare Provider Details

I. General information

NPI: 1962356485
Provider Name (Legal Business Name): JACOB SEARLS
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/23/2026
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 PRADO DR
HURRICANE WV
25526-1083
US

IV. Provider business mailing address

131 PRADO DR
HURRICANE WV
25526-1083
US

V. Phone/Fax

Practice location:
  • Phone: 304-541-8673
  • Fax:
Mailing address:
  • Phone: 304-541-8673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: