Courtney Kennedy
Individual provider Active NPI Community Health Worker · Jolo, WV
NPI 1194458562 · NPPES record last updated Jul 5, 2022
Key facts
- NPI
- 1194458562
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 1306 Three Forks Hwy
Jolo, WV 24850 - Phone
- (304) 988-4200
- NPI assigned
- Jul 5, 2022
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
1306 Three Forks Hwy
Jolo, WV 24850
Mailing address
1306 Three Forks Hwy
Jolo, WV 24850
Phone (304) 988-4200
Other providers in Jolo, WV
- Brittany Arndt
- Alexandra Bales
- Josie Day
- Christy Dellinger
- Holly Hagerman
- Miranda Ann Mullins
- Daniel J Puckett
- Joyce Rowe
- Kevin Rowe
- Wendy Stacey
All providers in Jolo, WV · Community Health Worker 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 Jul 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.