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General NPI Number Information
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NPI Number | 1083633937
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Entity Type | Individual
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Provider Name | JENNIFER R RIFFE PAC
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Gender | Female
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Dates
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Enumeration Date | 07/19/2006
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Last Update Date | 05/07/2008
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Provider Practice Location Address
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Address Line | 3997 BECKLEY RD
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City | PRINCETON
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State | WV
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Zip | 24740-7660
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Country | US
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Telephone | 304-431-5499
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Fax | 304-431-3400
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Provider Business Mailing Address
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Address Line | PO BOX 1106
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City | FREEMAN
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State | WV
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Zip | 24724
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Country | US
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Telephone | 304-589-6399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 686
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License Number State | WV
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