Healthcare Provider Details

I. General information

NPI: 1720792633
Provider Name (Legal Business Name): CARLEE ROCHELLE ADKINS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2023
Last Update Date: 01/06/2023
Certification Date: 01/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 PHILLIP KUHN RD
OAK HILL OH
45656-9645
US

IV. Provider business mailing address

298 TRICORN RD
DANVILLE WV
25053-7148
US

V. Phone/Fax

Practice location:
  • Phone: 740-418-5549
  • Fax:
Mailing address:
  • Phone: 304-369-1385
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number115096
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: