Tracy Rush
Individual provider Active NPI Personal Care Attendant · Granttown, WV
NPI 1639859770 · NPPES record last updated Jul 24, 2023
Key facts
- NPI
- 1639859770
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 202 Ballah Ave
Granttown, WV 26574 - Phone
- (304) 657-9093
- NPI assigned
- Jul 24, 2023
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Personal Care Attendant | 3747P1801X | Yes |
Addresses
Primary practice location
202 Ballah Ave
Granttown, WV 26574
Mailing address
PO Box 393
Grant Town, WV 26574-0393
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 24, 2023. 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.