Jody Stevens

Individual provider Active NPI Personal Care Attendant · Mount Perry, OH

NPI 1013320944 · NPPES record last updated Jun 9, 2014

Key facts

NPI
1013320944
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
License
RG136689 (OH)
Practice address
6460 Kroft Rd
Mount Perry, OH 43760-9707
Phone
(740) 644-6958
NPI assigned
Jun 9, 2014
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

State licenses

LicenseStateTypeSpecialty
RG136689OHMDPersonal Care Attendant

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X RG136689 OH Yes
Homemaker 376J00000X RG136689 OH

Addresses

Primary practice location

6460 Kroft Rd
Mount Perry, OH 43760-9707

Mailing address

6460 Kroft Rd
Mount Perry, OH 43760-9707
Phone (740) 644-6958

Other identifiers

IdentifierTypeStateIssuer
0099693MedicaidOH
0099693OtherOHLV1

Other providers in Mount Perry, OH

All providers in Mount Perry, OH · Personal Care Attendant in Ohio

Sources for this page

Verify at the official NPI Registry.