Provider Demographics
NPI:1457798266
Name:BILLER, JODI H (FNP-BC)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:H
Last Name:BILLER
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:JODI
Other - Middle Name:D
Other - Last Name:HAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:300 CORPORATE CENTER DR.
Mailing Address - Street 2:
Mailing Address - City:SCOTT DEPOT
Mailing Address - State:WV
Mailing Address - Zip Code:25560
Mailing Address - Country:US
Mailing Address - Phone:304-691-6800
Mailing Address - Fax:
Practice Address - Street 1:300 CORPORATE CENTER DR.
Practice Address - Street 2:
Practice Address - City:SCOTT DEPOT
Practice Address - State:WV
Practice Address - Zip Code:25560
Practice Address - Country:US
Practice Address - Phone:304-691-6800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-03
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN70757363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV3910000593Medicaid
WV3910000593Medicaid