Eleanor Gail Jessen, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

36946 Issued in WV

Practice address

1740 Coonskin Dr
Charleston, WV 25311-1026

Phone

(304) 561-6324

Fax

(304) 561-6326

NPI assigned

Jan 15, 2010

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Eleanor Gail Smith Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263513600000",
    "number": "1205167285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "588 BAKERS RIDGE RD",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265081517",
            "telephone_number": "304-550-2907",
            "fax_number": "304-561-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1740 COONSKIN DR",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253111026",
            "telephone_number": "304-561-6324",
            "fax_number": "304-561-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JESSEN",
        "first_name": "ELEANOR",
        "middle_name": "GAIL",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-15",
        "last_updated": "2010-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "36946",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELEANOR",
            "last_name": "SMITH",
            "middle_name": "GAIL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Family Nurse Practitioner in Charleston, WV
• Providers in Charleston, WV by specialty
• Family Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.