Taylor Johnson

Individual provider Active NPI Personal Care Attendant · Wallace, WV

NPI 1154932424 · NPPES record last updated Jun 29, 2021

Key facts

NPI
1154932424
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
792 Quaker Fork Rd
Wallace, WV 26448-8911
Phone
(304) 291-9066
NPI assigned
Aug 11, 2020
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
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

792 Quaker Fork Rd
Wallace, WV 26448-8911

Mailing address

792 Quaker Fork Rd
Wallace, WV 26448-8911
Phone (304) 291-9066

Other providers in Wallace, WV

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

Sources for this page

Verify at the official NPI Registry.