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Kelsie Johnson

Technician, Personal Care Attendant in Madison, WV. Individual provider (NPI-1).

NPI number1962003145
StatusActive
Last updated in NPPESNov 4, 2020

Details

NPI
1962003145
Entity type
Individual (NPI-1)
Name
Kelsie Johnson
Sex
Female
Sole proprietor
No
Enumeration date
Nov 4, 2020
Certification date
Nov 4, 2020
Last updated
Nov 4, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3747P1801X Technician, Personal Care Attendant––Yes

Practice location

1 Avenue C Ste 102
Madison, WV 25130-1100

Phone 304-369-6400

Mailing address

1 Avenue C Ste 102
Madison, WV 25130-1100

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