Healthcare Provider Details

I. General information

NPI: 1568352326
Provider Name (Legal Business Name): KATHERINE OBRIAN
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2025
Last Update Date: 07/03/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3614 PIEDMONT RD
HUNTINGTON WV
25704-1929
US

IV. Provider business mailing address

3614 PIEDMONT RD
HUNTINGTON WV
25704-1929
US

V. Phone/Fax

Practice location:
  • Phone: 304-840-9499
  • 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: