Healthcare Provider Details

I. General information

NPI: 1093636292
Provider Name (Legal Business Name): JOURDAN RAMAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

318 ROSE ST APT 2
MANNINGTON WV
26582-1148
US

IV. Provider business mailing address

318 ROSE ST APT 2
MANNINGTON WV
26582-1148
US

V. Phone/Fax

Practice location:
  • Phone: 304-502-3086
  • Fax:
Mailing address:
  • Phone: 304-502-3086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: