Tracy Dawn Podunavac
Individual provider Active NPI Personal Care Attendant · Hewett, WV
NPI 1780468926 · NPPES record last updated Aug 21, 2023
Key facts
- NPI
- 1780468926
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Personal Care Attendant 3747P1801X
- Practice address
- 3338 Missouri Fork Rd
Hewett, WV 25108-9637 - Phone
- (304) 687-2099
- NPI assigned
- Aug 21, 2023
- 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
3338 Missouri Fork Rd
Hewett, WV 25108-9637
Mailing address
3338 Missouri Fork Rd
Hewett, WV 25108-9637
Phone (304) 687-2099
Other providers in Hewett, WV
All providers in Hewett, 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 Aug 21, 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.