Polly Jane Dillon

Individual provider Active NPI Personal Care Attendant · Kenova, WV

NPI 1962012948 · NPPES record last updated Aug 5, 2020

Key facts

NPI
1962012948
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
820 Poplar St
Kenova, WV 25530-1530
Phone
(304) 453-4992
Fax
(304) 453-5574
NPI assigned
Aug 5, 2020
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)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

820 Poplar St
Kenova, WV 25530-1530

Mailing address

820 Poplar St
Kenova, WV 25530-1530
Phone (304) 453-4992

Other practice location 1

170 Terrace Dr Apt 9
Wayne, WV 25570-6015
Phone (304) 360-8027

Other providers in Kenova, WV

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

Sources for this page

Verify at the official NPI Registry.