Healthcare Provider Details

I. General information

NPI: 1306503727
Provider Name (Legal Business Name): NOVEMBER RAIN HERSHMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/19/2021
Last Update Date: 11/19/2021
Certification Date: 11/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 SQUIRREL TAIL LN
HAMBLETON WV
26269-8029
US

IV. Provider business mailing address

501 WILSON LN
ELKINS WV
26241-5216
US

V. Phone/Fax

Practice location:
  • Phone: 681-270-0997
  • Fax:
Mailing address:
  • Phone: 304-636-9326
  • Fax:

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: