JENIFFER RACHELLE WICKLINE (NPI# 1013517259) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013517259 |
| Entity Type | Individual |
| Full Name | JENIFFER RACHELLE WICKLINE |
| Credential | APRN, FNP-BC |
| Practice Address |
1265 Maplewood Ave Lewisburg WV 24901-9478 |
| Practice Telephone | 3046452700 |
| Practice Fax Number | 3046453188 |
| Mailing Telephone | 3046452700 |
| Mailing Fax Number | 3046453188 |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
106770 | WV | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1265 MAPLEWOOD AVE |
| City | LEWISBURG |
| State | WV |
| Zip Code | 24901-9478 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861093940 | Amy Lu Moss | Technician | 254 Moss D Lane, Fairlea, WV 24901 | 2020-11-04 |
| 1083212377 | Miranda Shope | Technician | 814 Maple Ave., Lewisburg, WV 24901 | 2020-10-09 |
| 1184235830 | Carol E Beasley | Technician | 147 Windy Hill Road, Lewisburg, WV 24901 | 2020-08-14 |
| 1790317782 | Preston Dyer Modlin | Psychologist | 635 Church Street, Lewisburg, WV 24901 | 2020-02-07 |
| 1437780269 | Healthcare 360 Pllc | Family Medicine | 208 Dawkins Drive, Lewisburg, WV 24901 | 2020-01-30 |
| 1821655390 | Janet Lee Kowalsky | Student in an Organized Health Care Education/Training Program | 1464 N Jefferson St., Lewisburg, WV 24901 | 2019-05-21 |
| 1598321192 | Ali Yousaf | Student in an Organized Health Care Education/Training Program | 400 North Jefferson, Lewisburg, WV 24901 | 2019-05-20 |
| 1770053308 | Micheala Renae Taylor | Student in an Organized Health Care Education/Training Program | 1464 North Jefferson Street, Lewisburg, WV 24901 | 2018-11-27 |
| 1659840486 | Maggie King Clendenen | Nurse Practitioner | 454 Bell Drive, Lewisburg, WV 24901 | 2018-11-22 |
| 1861979312 | Vincent Morra | Student in an Organized Health Care Education/Training Program | 1464 N Jefferson St, Lewisburg, WV 24901 | 2018-07-26 |
| Find all providers in zip 24901 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154985018 | Nicole Megan Grinnell | Nurse Practitioner | 1261 Old Highway 99, Lewisburg, TN 37091-6638 | 2019-04-26 |
| 1982165353 | Breanna Wood | Nurse Practitioner | 641 E Commerce St, Lewisburg, TN 37091-2816 | 2019-03-28 |
| 1609256676 | Hannah Broadwater | Nurse Practitioner | 296 Fair St, Lewisburg, WV 24901-2632 | 2015-06-04 |
| 1386986255 | Meagan Brittany Farley | Nurse Practitioner | 1701 Childress Rd, Lewisburg, TN 37091-7152 | 2013-03-19 |
| 1740531938 | Christy Stapleton | Nurse Practitioner | 201 Garrett Pkwy, Lewisburg, TN 37091-3552 | 2012-09-27 |
| 1780961987 | Shelly Marie Hargrove | Nurse Practitioner | 1090 N Ellington Pkwy Ste 102, Lewisburg, TN 37091-2227 | 2011-11-16 |
| 1386892487 | Tambra Michelle Pitt | Nurse Practitioner | 3738 Davis Stuart Rd., Lewisburg, WV 24901-9463 | 2008-09-03 |
| 1962608992 | Melissa A. Neal | Nurse Practitioner | 551 Springplace Rd, Lewisburg, TN 37091-3447 | 2007-06-26 |
| 1407925399 | Julia S Bryan | Nurse Practitioner | 335 1st Ave N, Lewisburg, TN 37091-2826 | 2006-11-07 |
| 1528542784 | Margaret Kimberly Murdock | Nurse Practitioner | 1090 N Ellington Pkwy, Lewisburg, TN 37091-2227 | 2018-09-23 |
| Find all providers in LEWISBURG | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.