SHRIVER FAMILY PRACTICE LTD. NPI 1043557390

NPI Information

NPI: 1043557390
Provider Name: SHRIVER FAMILY PRACTICE LTD.
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 36D2149842

Address:
294 E MAIN ST
JACKSON, OH
ZIP 45640
Phone: (740) 577-3132
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SHRIVER FAMILY PRACTICE LTD. is a family nurse practitioner in Jackson, OH. SHRIVER FAMILY PRACTICE LTD. NPI is 1043557390. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

294 E MAIN ST
JACKSON, OH
ZIP 45640-745
Phone: (740) 577-3132
Fax: (740) 577-3156

The provider's authorized official is Jeanetta J Shriver .
The authorized official title is Owner and has the following contact phone number (740) 577-3132.

The CLIA number assigned to this NPI record is 36D2149842 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/7/2013 and was last updated on 1/7/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	COA12752	OHIO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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