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General NPI Number Information
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NPI Number | 1235939588
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Entity Type | Organization
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Legal Business Name | CJS MEDICAL
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Dates
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Enumeration Date | 03/17/2025
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 705 CLEARVIEW DR
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City | VINTON
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State | VA
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Zip | 24179-3605
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Country | US
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Telephone | 540-525-5099
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Fax |
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Provider Business Mailing Address
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Address Line | 306 WESLEY RD
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City | DALEVILLE
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State | VA
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Zip | 24083-3068
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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 | CREDENTIALING SPECIALIST
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Name | HILLARY NICOLE MARSHALL
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Credential |
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Telephone | 540-480-6026
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number |
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License Number State |
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