Provider Demographics
NPI:1578225298
Name:GREER, JESSICA LOUISE
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:LOUISE
Last Name:GREER
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 1:9468 WOLF CREEK RD
Mailing Address - Street 2:
Mailing Address - City:WOLFCREEK
Mailing Address - State:WV
Mailing Address - Zip Code:24993-3910
Mailing Address - Country:US
Mailing Address - Phone:304-445-5628
Mailing Address - Fax:
Practice Address - Street 1:9468 WOLF CREEK RD
Practice Address - Street 2:
Practice Address - City:WOLFCREEK
Practice Address - State:WV
Practice Address - Zip Code:24993-3910
Practice Address - Country:US
Practice Address - Phone:304-445-5628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-11
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant