Healthcare Provider Details

I. General information

NPI: 1659165173
Provider Name (Legal Business Name): CHARLI D TOPARIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300B PRESTIGE PARK DR
HURRICANE WV
25526-8419
US

IV. Provider business mailing address

95 HICKORY LN
MADISON WV
25130-1215
US

V. Phone/Fax

Practice location:
  • Phone: 304-202-3864
  • Fax:
Mailing address:
  • Phone: 304-206-8588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number83719
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: