Provider Demographics
NPI:1720769508
Name:JEBBIA, MADISON MELANIE
Entity Type:Individual
Prefix:
First Name:MADISON
Middle Name:MELANIE
Last Name:JEBBIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 SPRINGHAVEN RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:WV
Mailing Address - Zip Code:26003-6022
Mailing Address - Country:US
Mailing Address - Phone:304-780-0224
Mailing Address - Fax:
Practice Address - Street 1:8 SPRINGHAVEN RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:WV
Practice Address - Zip Code:26003-6022
Practice Address - Country:US
Practice Address - Phone:304-780-0224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-26
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program