Crystal Clem

Individual provider Active NPI Personal Care Attendant · Weston, WV

NPI 1114697232 · NPPES record last updated Oct 25, 2021

Key facts

NPI
1114697232
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
171 W 2ND St
Weston, WV 26452-1665
Phone
(304) 269-5738
NPI assigned
Sep 20, 2021
Sex
Female
Sole proprietor
No

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
Homemaker 376J00000X
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

171 W 2ND St
Weston, WV 26452-1665

Mailing address

171 W 2ND St
Weston, WV 26452-1665
Phone (304) 269-5738

Other providers in Weston, WV

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

Sources for this page

Verify at the official NPI Registry.