Healthcare Provider Details

I. General information

NPI: 1356107254
Provider Name (Legal Business Name): LORETTA DINGESS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2024
Last Update Date: 02/27/2024
Certification Date: 02/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2037 SHOCKEY RD
OLD FIELDS WV
26845-8036
US

IV. Provider business mailing address

10 MAPLE HILL AVE STE 5
PETERSBURG WV
26847-1590
US

V. Phone/Fax

Practice location:
  • Phone: 681-231-9007
  • Fax:
Mailing address:
  • Phone: 304-250-4545
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: