Jimmy Lynn Eagle
Individual provider Active NPI Personal Care Attendant · Beverly, WV
NPI 1407466014 · NPPES record last updated Jun 29, 2021
Key facts
- NPI
- 1407466014
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 24 Hemlock Dr
Beverly, WV 26253-4554 - Phone
- (304) 636-9326
- NPI assigned
- Aug 7, 2020
- Sex
- Male
- 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
24 Hemlock Dr
Beverly, WV 26253-4554
Mailing address
501 Wilson LN
Elkins, WV 26241-5216
Phone (304) 636-9326
Other providers in Beverly, WV
- Janice Lea Daniels
- Megan Daniels
- Megan Dewitt
- Danielle M Dougherty
- Aaron Eagle
- Kimberly Dawn Eagle
- Zachery Lee Eagle
- Christina Elbon
- Rose Ellison
- Maureen Catherine Farrell
All providers in Beverly, 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 Jun 29, 2021. 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.