Wanda S Massie

Individual provider Active NPI Personal Care Attendant · Winchester, OH

NPI 1003415217 · NPPES record last updated Oct 19, 2020

Key facts

NPI
1003415217
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
3081 Cross Rd
Winchester, OH 45697-9749
Phone
(937) 217-3341
NPI assigned
Oct 19, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Supports Brokerage Agency 251X00000X
In Home Supportive Care Agency 253Z00000X
Private Vehicle 347C00000X
Homemaker 376J00000X
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

3081 Cross Rd
Winchester, OH 45697-9749

Mailing address

3081 Cross Rd
Winchester, OH 45697-9749
Phone (937) 217-3341

Other identifiers

IdentifierTypeStateIssuer
0100750MedicaidOH

Other providers in Winchester, OH

All providers in Winchester, OH · Personal Care Attendant in Ohio

Sources for this page

Verify at the official NPI Registry.