IDA MICHELLE BREEDEN NPI 1023613106

NPI Information

NPI: 1023613106
Provider Name: IDA MICHELLE BREEDEN
Classification: Technician - 3747P1801X
Entity Type: Individual

Specialization: Personal Care Attendant

Address:
600 TRENT STREET
PRINCTON, WV
ZIP 24701
Phone: (304) 425-7111
Get Directions

Ida Michelle Breeden is a personal care attendant technician in Princton, WV. The provider is 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 Ida Michelle Breeden NPI is 1023613106. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

600 TRENT STREET
PRINCTON, WV
ZIP 24701
Phone: (304) 425-7111
Fax: (304) 425-1138

The enumeration date for this NPI number is 12/4/2020 and was last updated on 12/14/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	376J00000X	Homemaker		1568796027	WEST VIRGINIA	No
2	3747P1801X	Technician	Personal Care Attendant	1568796027	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	55-6025355	MEDICAID	WEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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