Healthcare Provider Details

I. General information

NPI: 1740174309
Provider Name (Legal Business Name): TESSA WYKLE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2025
Last Update Date: 06/06/2025
Certification Date: 06/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1021 ELIZABETH ST
OAK HILL WV
25901-2349
US

IV. Provider business mailing address

1021 ELIZABETH ST
OAK HILL WV
25901-2349
US

V. Phone/Fax

Practice location:
  • Phone: 304-719-7997
  • 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: