Search › West Virginia › 363LP2300X
Angel Jackson
NPI 1407560402 · on the registry since 2023
Practice
- Address
- 400 S Ruffner Rd Ste 11
Charleston, WV 25314 - Phone
- (304) 720-9595
- Clinicians at this address
- 4
Registry record
- Primary taxonomy
- 363LP2300X
363LP2300X
- Also registered as
- 163W00000X
- Licence states on file
- WV
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2026-07-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in West Virginia