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NPI Code Detail

MEDICARE: SUSAN ALEXIS FAIN

MEDICARE:   SUSAN ALEXIS FAIN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1326646241
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN ALEXIS FAIN
Provider Business Mailing Address
First Line : 131 SILVER SPRINGS AVE
Second Line :
City : PRINCETON
State : WV
Zip : 24740-2848
Country : US
Telephone Number : 304-922-2457
Fax Number :
Provider Business Practice Location Address
First Line : 131 SILVER SPRINGS AVE
Second Line :
City : PRINCETON
State : WV
Zip : 24740-2848
Country : US
Telephone Number : 304-922-2457
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/13/2020
Last Update Date : 10/13/2020

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Directions to “ SUSAN ALEXIS FAIN ” Practice Location

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