Healthcare Provider Details

I. General information

NPI: 1235052853
Provider Name (Legal Business Name): AMBER HOLSTEIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 RUCKER ST
MADISON WV
25130-1125
US

IV. Provider business mailing address

313 RUCKER ST
MADISON WV
25130-1125
US

V. Phone/Fax

Practice location:
  • Phone: 681-438-9425
  • Fax:
Mailing address:
  • Phone: 681-438-9425
  • 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: