Pamela Faye Douglas
Home Health Aide in Ivydale, WV. Individual provider (NPI-1).
NPI number1619704939
StatusActive
Last updated in NPPESSep 19, 2024
Details
- NPI
- 1619704939
- Entity type
- Individual (NPI-1)
- Name
- Pamela Faye Douglas
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 19, 2024
- Certification date
- Sep 19, 2024
- Last updated
- Sep 19, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 374U00000X | Home Health Aide | – | – | Yes |
Practice location
529 Rush Fork RdIvydale, WV 25113-8177
Phone 304-286-4075
Mailing address
529 Rush Fork RdIvydale, WV 25113-8177
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