Healthcare Provider Details

I. General information

NPI: 1992621809
Provider Name (Legal Business Name): JESSICA DILLOW-PRICE APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2026
Last Update Date: 06/25/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 12TH ST
PRINCETON WV
24740-2312
US

IV. Provider business mailing address

815 HEATHERWOOD RD
BLUEFIELD WV
24701-4230
US

V. Phone/Fax

Practice location:
  • Phone: 304-487-7000
  • Fax:
Mailing address:
  • Phone: 304-888-6466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number109245
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: