Victoria Rose Cross

Individual provider Active NPI Personal Care Attendant · Proctor, WV

NPI 1972288488 · NPPES record last updated Jun 21, 2023

Key facts

NPI
1972288488
Entity type
Individual (NPI type 1)
Primary specialty
Personal Care Attendant 3747P1801X
Practice address
1996 Rines Ridge Rd
Proctor, WV 26055-4046
Phone
(304) 650-0306
NPI assigned
Jun 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)CodeLicenseStatePrimary
Personal Care Attendant 3747P1801X Yes

Addresses

Primary practice location

1996 Rines Ridge Rd
Proctor, WV 26055-4046

Mailing address

1996 Rines Ridge Rd
Proctor, WV 26055-4046
Phone (304) 650-0306

Other identifiers

IdentifierTypeStateIssuer
1356607394MedicaidWV
1821206228MedicaidWV
125553494MedicaidWV

Other providers in Proctor, WV

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

Sources for this page

Verify at the official NPI Registry.