Eureka, Tia Danielle

Eureka, Tia Danielle is an individual health care provider with primary practice located at 734 Long Run Ln , Proctor WV 26055-4275. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Eureka, Tia Danielle can be contacted via phone (304) 843-0360.

Contact Information

Primary practice address
734 Long Run Ln Proctor WV 26055-4275
Phone: (304) 843-0360
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Personal Care Attendant 3747P1801X

Profile Details

NPI number 1508506635
LBN Legal business name Eureka, Tia Danielle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 2022
Last updated Mar 29th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1508506635 NPPES
West Virginia MEDICAID 1356607394
West Virginia MEDICAID 125553494
West Virginia MEDICAID 1821206228

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