Provider Demographics
NPI:1285391565
Name:WEST, POLLY-ANNA JEAN
Entity type:Individual
Prefix:
First Name:POLLY-ANNA
Middle Name:JEAN
Last Name:WEST
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 1:806 MONTICELLO ST
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-2973
Mailing Address - Country:US
Mailing Address - Phone:606-305-8776
Mailing Address - Fax:
Practice Address - Street 1:806 MONTICELLO ST
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-2973
Practice Address - Country:US
Practice Address - Phone:606-305-8776
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator