Provider Demographics
NPI:1588275416
Name:DINGESS, GRETA ANN
Entity type:Individual
Prefix:
First Name:GRETA
Middle Name:ANN
Last Name:DINGESS
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:PO BOX 3
Mailing Address - Street 2:
Mailing Address - City:VERDUNVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:25649-0003
Mailing Address - Country:US
Mailing Address - Phone:304-784-0991
Mailing Address - Fax:
Practice Address - Street 1:3890 MUD FORK ROAD
Practice Address - Street 2:
Practice Address - City:VERDUNVILLE
Practice Address - State:WV
Practice Address - Zip Code:25649
Practice Address - Country:US
Practice Address - Phone:304-784-0991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant