Provider Demographics
NPI:1114518123
Name:JARVIS, STEVEN LEE (APRN)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:LEE
Last Name:JARVIS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7400 LYNN AVE
Mailing Address - Street 2:
Mailing Address - City:HAMLIN
Mailing Address - State:WV
Mailing Address - Zip Code:25523-1138
Mailing Address - Country:US
Mailing Address - Phone:304-824-5806
Mailing Address - Fax:304-824-5885
Practice Address - Street 1:1563 SAND PLANT RD
Practice Address - Street 2:
Practice Address - City:SOUTH CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25309-6120
Practice Address - Country:US
Practice Address - Phone:304-756-1500
Practice Address - Fax:304-756-1548
Is Sole Proprietor?:No
Enumeration Date:2021-02-02
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WV108504363LF0000X
WV85917163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily