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NPI Code Detail

MEDICARE: JESSICA SANDY

MEDICARE: JESSICA SANDY
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 : 1952905713
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA SANDY
Provider Business Mailing Address
First Line : 66 SAND RUN RD
Second Line :
City : WESTON
State : WV
Zip : 26452-7320
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 307 11TH ST
Second Line :
City : ELKINS
State : WV
Zip : 26241-3517
Country : US
Telephone Number : 681-298-5050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2020
Last Update Date : 11/23/2020

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Directions to “ JESSICA SANDY ” Practice Location

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