Provider Demographics
NPI:1134225444
Name:RANSON, JACQUELINE C (FNP-BC)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:C
Last Name:RANSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:C
Other - Last Name:O'NEIL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1563 SAND PLANT RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25309-6120
Mailing Address - Country:US
Mailing Address - Phone:304-756-1500
Mailing Address - Fax:304-756-1548
Practice Address - Street 1:7400 LYNN AVE
Practice Address - Street 2:
Practice Address - City:HAMLIN
Practice Address - State:WV
Practice Address - Zip Code:25523-1138
Practice Address - Country:US
Practice Address - Phone:304-824-5806
Practice Address - Fax:304-824-5804
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2015-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV57338363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVP01063394OtherMEDICARE RAILROAD
WV002065099OtherHIGHAMRK BCBS
WV7103096000Medicaid
WVWV2508B662Medicare Oscar/Certification
WV002065099OtherHIGHAMRK BCBS
WV7103096000Medicaid
WVWV2508DMedicare Oscar/Certification
WVRANP11192Medicare PIN
WVWV2508B663Medicare Oscar/Certification
WVWV2508EMedicare Oscar/Certification
WVWV2508HMedicare Oscar/Certification
WVWV2508FMedicare Oscar/Certification
WVWV2508CMedicare Oscar/Certification
WVWV2508GMedicare Oscar/Certification