| Ms Jennifer Lynn Thayer, PA-C | |
|
107 Koontz Ave Ste 200, Clendenin, WV 25045-9581 | |
| (304) 548-7272 | |
| (304) 548-7149 |
| Full Name | Ms Jennifer Lynn Thayer |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 107 Koontz Ave Ste 200, Clendenin, West Virginia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811249956 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | 01691 (West Virginia) | Primary |
| Entity Name | Charleston Area Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124248752 PECOS PAC ID: 3375441637 Enrollment ID: O20031223000426 |
| Entity Name | Cabin Creek Health Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1366495525 PECOS PAC ID: 2466431101 Enrollment ID: O20130905000096 |
| Mailing Address | Practice Location Address |
|---|---|
| Ms Jennifer Lynn Thayer, PA-C 104 Alex Ln, Charleston, WV 25304-2952 Ph: (304) 734-2040 | Ms Jennifer Lynn Thayer, PA-C 107 Koontz Ave Ste 200, Clendenin, WV 25045-9581 Ph: (304) 548-7272 |
Rachael D. Mitchell, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 107 Koontz Ave Ste 200, Clendenin, WV 25045 Phone: 304-548-7272 Fax: 304-548-7149 |
Chelsea Agnew, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 107 Koontz Ave Ste 200, Clendenin, WV 25045 Phone: 304-548-7272 |
Mary E Grandon, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 107 Koontz Ave. Ste. 200, Clendenin, WV 25045 Phone: 304-548-7272 Fax: 304-548-7149 |
Trenton Ryan Johnson, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 107 Koontz Ave Ste 200, Clendenin, WV 25045 Phone: 304-548-7272 Fax: 304-542-7149 |