Provider Demographics
NPI:1952976318
Name:GARRETT, JORETTA JEAN
Entity Type:Individual
Prefix:
First Name:JORETTA
Middle Name:JEAN
Last Name:GARRETT
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 1:27 ROBINSON RUN RD
Mailing Address - Street 2:
Mailing Address - City:MAIDSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26541-8049
Mailing Address - Country:US
Mailing Address - Phone:681-285-1102
Mailing Address - Fax:
Practice Address - Street 1:27 ROBINSON RUN RD
Practice Address - Street 2:
Practice Address - City:MAIDSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26541-8049
Practice Address - Country:US
Practice Address - Phone:681-285-1102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2021-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant