Healthcare Provider Details

I. General information

NPI: 1669381687
Provider Name (Legal Business Name): JAMALYN MAE WORKMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

84 FERRIS DRIVE
GLEN FERRIS WV
25090
US

IV. Provider business mailing address

PO BOX 115
GAULEY BRIDGE WV
25085-0115
US

V. Phone/Fax

Practice location:
  • Phone: 304-900-3172
  • Fax:
Mailing address:
  • Phone: 304-900-3172
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: