Provider Demographics
NPI:1760105068
Name:JARRETT, JAMES BRAYDEN
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:BRAYDEN
Last Name:JARRETT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 STATION ST
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-7442
Mailing Address - Country:US
Mailing Address - Phone:304-291-9066
Mailing Address - Fax:
Practice Address - Street 1:5000 STATION ST
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-7442
Practice Address - Country:US
Practice Address - Phone:304-291-9066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-21
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator