Penny Jane Baker
Individual provider Active NPI Personal Care Attendant · Pine Grove, WV
NPI 1194452532 · NPPES record last updated Aug 5, 2022
Key facts
- NPI
- 1194452532
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 34 Etna Street
Pine Grove, WV 26419-0121 - Phone
- (304) 815-1349
- NPI assigned
- Aug 5, 2022
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
34 Etna Street
Pine Grove, WV 26419-0121
Mailing address
PO Box 121
Pine Grove, WV 26419-0121
Phone (304) 815-1349
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356607394 | Medicaid | WV | |
| 1821206228 | Medicaid | WV | |
| 125553494 | Medicaid | WV |
Other providers in Pine Grove, WV
- Angela D Adams
- Sharon Lee Gump
- Cindy Howell
- Shane Michael Lambert
- Renee Nicole McDougal
- Tracy Pearl Myers
All providers in Pine Grove, WV · Personal Care Attendant in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 5, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.