Jacqueline McDonough

Individual provider Active NPI Home Health Aide · Kenna, WV

NPI 1225926702 · NPPES record last updated Jun 25, 2025

Key facts

NPI
1225926702
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Aide 374U00000X
Practice address
4184 Sugar Creek Rd
Kenna, WV 25248-6095
Phone
(304) 550-0606
NPI assigned
Jun 25, 2025
Sex
Unspecified or another gender identity
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
Home Health Aide 374U00000X Yes

Addresses

Primary practice location

4184 Sugar Creek Rd
Kenna, WV 25248-6095

Mailing address

4184 Sugar Creek Rd
Kenna, WV 25248-6095

Other providers in Kenna, WV

All providers in Kenna, WV · Home Health Aide in West Virginia

Sources for this page

Verify at the official NPI Registry.