Healthcare Provider Details

I. General information

NPI: 1043125461
Provider Name (Legal Business Name): VICKIE WEBB
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N KANAWHA ST
BECKLEY WV
25801-4717
US

IV. Provider business mailing address

425 S FAYETTE ST
BECKLEY WV
25801-5403
US

V. Phone/Fax

Practice location:
  • Phone: 304-222-5532
  • Fax:
Mailing address:
  • Phone: 304-222-5532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: