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General NPI Number Information
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NPI Number | 1922811033
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Entity Type | Individual
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Provider Name | JESSICA HARTMAN HIS
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Gender | Female
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 1191 PINEVIEW DR STE H3
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City | MORGANTOWN
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State | WV
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Zip | 26505-2778
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Country | US
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Telephone | 304-599-6762
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Fax | 304-205-0672
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Provider Business Mailing Address
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Address Line | 175 MEADOW RUN RD
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City | MT MORRIS
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State | PA
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Zip | 15349-1397
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Country | US
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Telephone | 724-880-5454
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 1130
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License Number State | WV
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