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NPI Code Detail

MEDICARE: CHRISTIAN SCOTT ENNIS

MEDICARE: CHRISTIAN SCOTT ENNIS
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 : 1750244224
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTIAN SCOTT ENNIS
Provider Business Mailing Address
First Line : 17 ROCK CREEK RD
Second Line :
City : MONTROSE
State : WV
Zip : 26283-7004
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 312 RAILROAD AVE
Second Line :
City : ELKINS
State : WV
Zip : 26241-3859
Country : US
Telephone Number : 304-637-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ CHRISTIAN SCOTT ENNIS ” Practice Location

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