Wallace, Alena Rae

Wallace, Alena Rae is an individual health care provider with primary practice located at 243 Blacklog Road , Fort Gay WV 25514. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Wallace, Alena Rae can be contacted via phone (304) 272-9025.

Contact Information

Primary practice address
243 Blacklog Road Fort Gay WV 25514
Fax:
Website:

Health care specialties

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

Profile Details

NPI number 1346755691
LBN Legal business name Wallace, Alena Rae
Credentials PCA
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 8th, 2017
Last updated Dec 8th, 2017 - about 7 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 1346755691 NPPES
Other 3810005997 PROVIDER ID

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