Provider Demographics
NPI:1376118232
Name:TONEY, JESSICA RENE' (APRN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:RENE'
Last Name:TONEY
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 183
Mailing Address - Street 2:
Mailing Address - City:OLD FIELDS
Mailing Address - State:WV
Mailing Address - Zip Code:26845-0183
Mailing Address - Country:US
Mailing Address - Phone:304-703-7262
Mailing Address - Fax:
Practice Address - Street 1:117 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:WV
Practice Address - Zip Code:26847-9566
Practice Address - Country:US
Practice Address - Phone:304-257-1026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV108359363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner