Jeannie M Rose
Individual provider Active NPI Personal Care Attendant · Glen Easton, WV
NPI 1316730476 · NPPES record last updated May 22, 2025
Key facts
- NPI
- 1316730476
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 7350 Fork Ridge Rd
Glen Easton, WV 26039-1401 - Phone
- (304) 238-6483
- NPI assigned
- May 22, 2025
- 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
7350 Fork Ridge Rd
Glen Easton, WV 26039-1401
Mailing address
7350 Fork Ridge Rd
Glen Easton, WV 26039-1401
Phone (304) 238-6483
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356607394 | Medicaid | WV | |
| 125553494 | Medicaid | WV | |
| 1821206228 | Medicaid | WV |
Other providers in Glen Easton, WV
- Stephani Leasure
- Ashley Ann Lucey
- Karlie N Moslander
- Brandi O'Neil
- Bonita Oneil
- Amanda Lynn Ross
- Jennie Lee Urban
All providers in Glen Easton, 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 May 22, 2025. 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.