NPI 1649812090 · live from the CMS NPI Registry
Jenna Lee Barraclough, PA-C
Physician Assistant in Martinsburg, WV. National Provider Identifier 1649812090, active.
NPI record
| NPI | 1649812090 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 1008 Tavern Rd Ste 102, Martinsburg, WV 25401 |
| Practice phone | 304-263-5129 |
| Mailing address | 220 Campus Blvd Ste 320, Winchester, VA 22601 |
| Enumerated | October 16, 2019 |
| Last updated | September 8, 2026 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant | 363A00000X | 57130 (CA) |
| Physician Assistant primary | 363A00000X | 1013 (WV) |
| Physician Assistant | 363A00000X | C0009982 (MD) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.