JORDAN WALLACE
NPI 1962391359
Home Health Aide in Man, WV
About Jordan Wallace NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
JORDAN WALLACE (NPI 1962391359) is an individual home health aide in Man, West Virginia and active in the NPI registry since June 2025.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Jordan Wallace's NPI number?
The NPI number for Jordan Wallace is 1962391359. It was assigned to this individual provider in the NPPES registry on June 30, 2025.
Where is Jordan Wallace located?
Jordan Wallace practices at 503 E Mcdonald Ave, Man, WV 25635. The listed phone number is (304) 687-0172.
What is Jordan Wallace's specialty?
The primary specialty registered for this NPI is Home Health Aide with taxonomy code 374U00000X.
When was this NPI record last updated?
The NPPES record for Jordan Wallace was last updated on June 30, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Jordan Wallace · NPI 1962391359
Home Health Aide provider in Man, West Virginia. Individual provider, active in the CMS NPPES registry since June 30, 2025.
## Identity
- **NPI:** 1962391359 (Entity type: Individual)
- **Enumerated:** June 30, 2025
- **Primary specialty:** Home Health Aide · taxonomy 374U00000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 503 E MCDONALD AVE, Man, WV 25635-1014
- **Phone:** (304) 687-0172
## Record status
- **NPPES last updated:** June 30, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1962391359) · Data from the CMS NPPES public registry.