Basic Information
| Provider Information | |||||||||
| NPI: | 1578912119 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOUSER | ||||||||
| FirstName: | JAMES | ||||||||
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| Credential: | CNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 121 KEAGLER DR | ||||||||
| Address2: | |||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439533632 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 4000 JOHNSON RD | ||||||||
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| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439522364 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402648067 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/04/2016 | ||||||||
| LastUpdateDate: | 12/13/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | APRN.CNP.19181 | OH | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 0170329 | 05 | OH | MEDICAID |