Jennifer Elaine Bodkins
Individual provider Active NPI Personal Care Attendant · Clay, WA
NPI 1366046138 · NPPES record last updated Dec 3, 2020
Key facts
- NPI
- 1366046138
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 15 Bank St
Clay, WA 25043 - Phone
- (304) 587-9992
- Fax
- (304) 587-9993
- NPI assigned
- Nov 23, 2020
- 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
15 Bank St
Clay, WA 25043
Mailing address
7403 Clay Hwy
Bickmore, WV 25019-9715
Phone (304) 587-7070
Other names
- Jennifer Elaine White
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2020. 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.