Healthcare Provider Details

I. General information

NPI: 1699388140
Provider Name (Legal Business Name): TRACI LYNN YONEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TRACI LYNN DEVILBISS

II. Dates (important events)

Enumeration Date: 08/25/2020
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 S EISENHOWER DR
BECKLEY WV
25801-4929
US

IV. Provider business mailing address

353 TRUMP ST
DANIELS WV
25832-9306
US

V. Phone/Fax

Practice location:
  • Phone: 304-256-7100
  • Fax: 304-256-7159
Mailing address:
  • Phone: 304-410-4914
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License NumberE844839
License Number StateWV
# 2
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: