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General NPI Number Information
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NPI Number | 1285430793
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Entity Type | Individual
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Provider Name | SONDRA IRENE KEARNS
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Gender | Female
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Dates
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Enumeration Date | 02/24/2025
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Last Update Date | 02/24/2025
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Provider Practice Location Address
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Address Line | 381 MAIN ST
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City | FOLLANSBEE
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State | WV
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Zip | 26037-1519
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Country | US
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Telephone | 304-533-8849
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Fax |
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Provider Business Mailing Address
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Address Line | 381 MAIN ST
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City | FOLLANSBEE
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State | WV
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Zip | 26037-1519
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Country | US
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Telephone | 304-533-8849
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3747P1801X
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Taxonomy Name | Personal Care Attendant
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License Number |
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License Number State |
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Legacy Identifiers
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Identifier #1
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Identifier Code | 1356607394
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Identifier Type | MEDICAID
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Identifier State | WV
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Identifier Issuer |
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Identifier #2
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Identifier Code | 1821206228
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Identifier Type | MEDICAID
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Identifier State | WV
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Identifier Issuer |
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Identifier #3
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Identifier Code | 125553494
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Identifier Type | MEDICAID
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Identifier State | WV
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Identifier Issuer |
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Proprietary Identifiers Ever Reported
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Identifier #1
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Identifier Code | 125553494
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Identifier Type | MEDICAID
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Identifier State | WV
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Identifier Issuer |
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Identifier #2
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Identifier Code | 1356607394
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Identifier Type | MEDICAID
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Identifier State | WV
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Identifier Issuer |
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Identifier #3
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Identifier Code | 1821206228
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Identifier Type | MEDICAID
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Identifier State | WV
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Identifier Issuer |
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