Healthcare Provider Details

I. General information

NPI: 1043186901
Provider Name (Legal Business Name): HANNAH M BURKHOLDER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2025
Last Update Date: 10/16/2025
Certification Date: 10/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 6TH AVE W
HUNTINGTON WV
25701-0028
US

IV. Provider business mailing address

10 6TH AVE W
HUNTINGTON WV
25701-0028
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-8014
  • Fax: 304-525-8026
Mailing address:
  • Phone: 304-525-8014
  • Fax: 304-525-8026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: