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General NPI Number Information
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NPI Number | 1306706924
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Entity Type | Individual
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Provider Name | GRACE ANNE HONAKER
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Gender | Female
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Dates
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Enumeration Date | 11/15/2025
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Last Update Date | 11/15/2025
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Provider Practice Location Address
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Address Line | 77 NORMAN MORGAN BLVD
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City | LOGAN
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State | WV
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Zip | 25601-3477
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Country | US
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Telephone | 304-752-7459
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1142
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City | MAN
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State | WV
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Zip | 25635-4142
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Country | US
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Telephone | 304-946-8520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 025355
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP0014827
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License Number State | WV
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