Provider Demographics
NPI:1497545909
Name:HUPP, JACQUELINE VIOLA
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:VIOLA
Last Name:HUPP
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:JACQUELINE
Other - Middle Name:VIOLA
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:44400 HUPP LANE
Mailing Address - Street 2:
Mailing Address - City:WOODSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:43793
Mailing Address - Country:US
Mailing Address - Phone:740-213-7084
Mailing Address - Fax:
Practice Address - Street 1:44400 HUPP LANE
Practice Address - Street 2:
Practice Address - City:WOODSFIELD
Practice Address - State:OH
Practice Address - Zip Code:43793
Practice Address - Country:US
Practice Address - Phone:740-213-7084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-08
Last Update Date:2025-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider