Greta Cochran

Individual provider Active NPI Personal Care Attendant · Kenna, WV

NPI 1083112593 · NPPES record last updated Jan 30, 2018

Key facts

NPI
1083112593
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
1793 Young Hollow Rd
Kenna, WV 25248
Phone
(304) 532-5193
NPI assigned
Jan 30, 2018
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
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

1793 Young Hollow Rd
Kenna, WV 25248

Mailing address

1793 Young Hollow Rd
Kenna, WV 25248
Phone (304) 532-5193

Other identifiers

IdentifierTypeStateIssuer
G20033904000OtherPROVIDER ID

Other providers in Kenna, WV

All providers in Kenna, WV · Personal Care Attendant in West Virginia

Sources for this page

Verify at the official NPI Registry.