Destiny Shay Ellis
Individual provider Active NPI Personal Care Attendant · Gilbert, WV
NPI 1629647771 · NPPES record last updated Jun 23, 2021
Key facts
- NPI
- 1629647771
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 14 Amberwood Dr
Gilbert, WV 25621-1528 - Phone
- (304) 785-3100
- NPI assigned
- Jun 23, 2021
- 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
14 Amberwood Dr
Gilbert, WV 25621-1528
Mailing address
14 Amberwood Dr
Gilbert, WV 25621-1528
Phone (304) 785-3100
Other providers in Gilbert, WV
- Sharon G Davis
- Dr L E Cole DDS Inc
- Eleanor Dawn Dugan
- Roy Dunn
- Elite Care EMS, LLC
- Joann Ellis
- Deborah Endicott
- Family Healthcare Associates Inc
- Gilbert Medical Center
- Gilbert Medical Center
All providers in Gilbert, 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 23, 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.