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General NPI Number Information
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NPI Number | 1174493340
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Entity Type | Individual
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Provider Name | JENNIFER ROGERS GILLIAN APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 11/11/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 1253 CANYON RD
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City | MORGANTOWN
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State | WV
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Zip | 26508-9273
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Country | US
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Telephone | 615-465-8684
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Fax | 629-240-6003
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Provider Business Mailing Address
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Address Line | 150 VAN BUREN LN
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City | BEAVER
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State | WV
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Zip | 25813-1327
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Country | US
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Telephone |
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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 | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 124051
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License Number State | WV
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