Healthcare Provider Details

I. General information

NPI: 1417849126
Provider Name (Legal Business Name): CARRIE ADKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

387 GOLDEN MEADOW LANE
MOUNT LOOKOUT WV
26678
US

IV. Provider business mailing address

PO BOX 82
MOUNT LOOKOUT WV
26678-0082
US

V. Phone/Fax

Practice location:
  • Phone: 304-618-2904
  • 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: