Healthcare Provider Details

I. General information

NPI: 1003486606
Provider Name (Legal Business Name): MRS. CHARMANAN TRINETTE HEATER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. CHARMANAN TRINETTE WOODS

II. Dates (important events)

Enumeration Date: 06/28/2021
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

219 HARTMAN RUN RD
MORGANTOWN WV
26505
US

IV. Provider business mailing address

PO BOX 745
DELLSLOW WV
26531
US

V. Phone/Fax

Practice location:
  • Phone: 304-292-6880
  • Fax: 304-292-6881
Mailing address:
  • Phone: 304-292-6880
  • Fax: 304-292-6881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: