MEDICARE: JENNIFER L WHALEY CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	70895	WV

General Provider Information

NPI Number	:	1174006357
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER L WHALEY CNP

Provider Business Mailing Address
First Line	:	1448 10TH AVE STE 304
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25701-3579
Country	:	US
Telephone Number	:	304-691-6381
Fax Number	:	304-691-8591

Provider Business Practice Location Address
First Line	:	94 BROOKSHIRE LN
Second Line	:
City	:	BECKLEY
State	:	WV
Zip	:	25801-6765
Country	:	US
Telephone Number	:	304-252-2673
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/13/2018
Last Update Date	:	02/02/2026

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