Alexis E Gillenwater

Individual provider Active NPI Community Health Worker · Yawkey, WV

NPI 1205429347 · NPPES record last updated Feb 19, 2021

Key facts

NPI
1205429347
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
72 Gillenwater Dr Apt 201
Yawkey, WV 25573-2000
Phone
(304) 549-9975
NPI assigned
Feb 19, 2021
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
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

72 Gillenwater Dr Apt 201
Yawkey, WV 25573-2000

Mailing address

72 Gillenwater Dr Apt 201
Yawkey, WV 25573-2000
Phone (304) 549-9975

Other providers in Yawkey, WV

All providers in Yawkey, WV · Community Health Worker in West Virginia

Sources for this page

Verify at the official NPI Registry.