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Jessica Dawn Clark
Personal Care Attendant in Moundsville, West Virginia
NPI 1174190755

Jessica Dawn Clark is a Personal Care Attendant based in Moundsville, WV and is specialized in Personal Care Attendant. Jessica Dawn Clark practices in Moundsville, WV. The NPI Number for Jessica Dawn Clark is 1174190755 and holds a License No. (West Virginia).

The current practice location address for Jessica Dawn Clark is 87 Swierkos Dr, Moundsville, WV and can be reached out via phone at 304-843-0910 and via fax at 304-843-0912. You can also correspond with Jessica Dawn Clark through the mailing address at 15 ELM AVE, MOUNDSVILLE, WV - 26041-1320 (mailing address contact number: 304-843-0910).

Location: 87 Swierkos Dr, Moundsville, WV, 26041-1320
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174190755
Provider Name
Jessica Dawn Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
87 Swierkos Dr, Moundsville, WV, 26041-1320
Phone Number
304-843-0910
Fax Number
304-843-0912
Provider Enumeration Date
06/10/2021
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1356607394 05 WV
125553494 05 WV
1821206228 05 WV
institution
Provider Business Practice Location Address Details
Address
87 Swierkos Dr
City
Moundsville
State
West Virginia
Zip
26041-4209
Phone Number
304-843-0910
Fax Number
304-843-0912
person
Provider Business Mailing Address Details
Address
15 Elm Ave
City
Moundsville
State
West Virginia
Zip
26041-1320
Phone Number
304-843-0910
Fax Number
304-843-0912
person
Provider's Taxonomy Details 1
Type
Nursing Service Related Providers
Classification
Technician
Speciality
Attendant Care Provider
Taxonomy
3747A0650X
License No.
()
Definition
An individual who provides hands-on care, of both a supportive and health related nature, specific to the needs of a medically stable, physically handicapped individual. Supportive services are those that substitute for the absence, loss, diminution, or impairment of a physical or cognitive function. This service may include skilled or nursing care to the extent permitted by state law.
person
Provider's Taxonomy Details 2
Type
Nursing Service Related Providers
Classification
Technician
Speciality
Personal Care Attendant
Taxonomy
3747P1801X
License No.
(West Virginia)
Definition
An individual who provides assistance with eating, bathing, dressing, personal hygiene, activities of daily living as specified in the plan of care. Services which are incidental to the care furnished, or essential to the health and welfare of the individual may also be provided. Personal care providers must meet state defined training and certification standards
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