Provider Demographics
NPI:1619933116
Name:PARSONS, JENNIFER K (PA-C)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:K
Last Name:PARSONS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:KATHLEEN
Other - Last Name:BURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3415 MACCORKLE SEAVE
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25304-1334
Mailing Address - Country:US
Mailing Address - Phone:304-388-8380
Mailing Address - Fax:304-388-8395
Practice Address - Street 1:200 ACADEMY DR
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:WV
Practice Address - Zip Code:25271-1157
Practice Address - Country:US
Practice Address - Phone:304-372-1050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV01027363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVQ10242Medicare UPIN
WVPA35491Medicare PIN