Provider Demographics
NPI:1558453480
Name:WOOD, JESSICA A (CFNP)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:WOOD
Suffix:
Gender:F
Credentials:CFNP
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 1615
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26507-1615
Mailing Address - Country:US
Mailing Address - Phone:304-599-8802
Mailing Address - Fax:304-599-5607
Practice Address - Street 1:2000 MON HEALTH MEDICAL PARK DRIVE
Practice Address - Street 2:SUITE 2300
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26505-0000
Practice Address - Country:US
Practice Address - Phone:304-599-8802
Practice Address - Fax:304-599-5607
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV55907363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily