Crystal Martin

Individual provider Active NPI Personal Care Attendant · Fairmont, WV

NPI 1366292906 · NPPES record last updated Mar 26, 2024

Key facts

NPI
1366292906
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
16 Mountain Park Dr
Fairmont, WV 26554-8992
Phone
(304) 816-3687
Fax
(304) 816-3737
NPI assigned
Mar 26, 2024
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
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

16 Mountain Park Dr
Fairmont, WV 26554-8992

Mailing address

16 Mountain Park Dr
Fairmont, WV 26554-8992
Phone (304) 816-3687

Other providers in Fairmont, WV

All providers in Fairmont, WV · Personal Care Attendant in West Virginia

Sources for this page

Verify at the official NPI Registry.