=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487858775
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JENNY LYNN CROSS M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/12/2007
-----------------------------------------------------
Last Update Date | 01/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 911 GORMAN AVE SUITE 2
-----------------------------------------------------
City | ELKINS
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26241-3082
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-637-6302
-----------------------------------------------------
Fax | 304-637-6307
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 911 GORMAN AVE
-----------------------------------------------------
City | ELKINS
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 26241-3082
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 304-637-6302
-----------------------------------------------------
Fax | 304-637-6307
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207YX0602X
-----------------------------------------------------
Taxonomy Name | Otolaryngic Allergy Physician
-----------------------------------------------------
License Number | 21597
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Y00000X
-----------------------------------------------------
Taxonomy Name | Otolaryngology Physician
-----------------------------------------------------
License Number | 21597
-----------------------------------------------------
License Number State | WV
-----------------------------------------------------