Provider Demographics
NPI:1417557752
Name:MAYFIELD, HARRIET VIRGINIA
Entity Type:Individual
Prefix:
First Name:HARRIET
Middle Name:VIRGINIA
Last Name:MAYFIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 FOOTHILLS LN
Mailing Address - Street 2:
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-4437
Mailing Address - Country:US
Mailing Address - Phone:304-322-1233
Mailing Address - Fax:
Practice Address - Street 1:114 CLEARWOOD DR
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-6240
Practice Address - Country:US
Practice Address - Phone:304-319-2733
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant