Healthcare Provider Details

I. General information

NPI: 1912818030
Provider Name (Legal Business Name): ASHLEY NICHOLE ROBERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 1/2 MAPLE ROAD
BEAVER WV
25813
US

IV. Provider business mailing address

275 CEMETERY DR
BEAVER WV
25813-8873
US

V. Phone/Fax

Practice location:
  • Phone: 835-220-2671
  • Fax:
Mailing address:
  • Phone: 838-220-2671
  • Fax: 838-220-2671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: