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General NPI Number Information
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NPI Number | 1801634084
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Entity Type | Individual
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Provider Name | JESSICA HUTTON
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Gender | Female
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Dates
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Enumeration Date | 07/19/2024
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 1513 HARRISON AVE STE A12
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City | ELKINS
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State | WV
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Zip | 26241-3356
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Country | US
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Telephone | 304-553-7063
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Fax | 304-591-1038
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Provider Business Mailing Address
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Address Line | 1111 VAN VOORHIS RD STE 2
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City | MORGANTOWN
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State | WV
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Zip | 26505-2737
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Country | US
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Telephone | 304-598-8900
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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 | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 164W00000X
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Taxonomy Name | Licensed Practical Nurse
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License Number | 37475
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License Number State | WV
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