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General NPI Number Information
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NPI Number | 1356889570
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Entity Type | Individual
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Provider Name | JEFFREY A MAYNARD II FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 02/08/2017
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 2550 CARTER AVE
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City | ASHLAND
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State | KY
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Zip | 41101-7830
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Country | US
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Telephone | 606-329-0727
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Fax | 606-329-1327
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Provider Business Mailing Address
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Address Line | 5786 CANNONSBURG RD
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City | CATLETTSBURG
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State | KY
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Zip | 41129-8221
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Country | US
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Telephone | 304-654-2504
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3016121
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN80198-FNP-BC
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License Number State | WV
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0028757
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License Number State | OH
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