Healthcare Provider Details

I. General information

NPI: 1477445153
Provider Name (Legal Business Name): ABIGAIL TOLER
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 CROSS LANE
HANOVER WV
24839
US

IV. Provider business mailing address

PO BOX 111
JUSTICE WV
24851-0111
US

V. Phone/Fax

Practice location:
  • Phone: 304-664-1041
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: