Jennifer Marie Vincent

Individual provider Active NPI Homemaker · Middlebourne, WV

NPI 1225779671 · NPPES record last updated Apr 7, 2022

Key facts

NPI
1225779671
Entity type
Individual (NPI type 1)
Primary specialty
Homemaker 376J00000X
Practice address
504 Cherry St
Middlebourne, WV 26149-9618
Phone
(304) 758-4919
Fax
(304) 758-4680
NPI assigned
Apr 7, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Council of Senior Tyler Countians, Inc. Past
since Apr 10, 2022
Accepting new patients
Council of Senior Tyler Countians, Inc. Past
since Apr 10, 2022
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Homemaker 376J00000X Yes

Addresses

Primary practice location

504 Cherry St
Middlebourne, WV 26149-9618

Mailing address

PO Box 68
Middlebourne, WV 26149-0068
Phone (304) 758-4919

Other providers in Middlebourne, WV

All providers in Middlebourne, WV · Homemaker in West Virginia

Sources for this page

Verify at the official NPI Registry.