Healthcare Provider Details

I. General information

NPI: 1750976841
Provider Name (Legal Business Name): JEANNIE MARIE DUNBAR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/02/2021
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 EWART AVE APT 42
BECKLEY WV
25801-3451
US

IV. Provider business mailing address

510 EWART AVE APT 42
BECKLEY WV
25801-3451
US

V. Phone/Fax

Practice location:
  • Phone: 681-323-1682
  • Fax:
Mailing address:
  • Phone: 681-323-1682
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: