=====================================================
General NPI Number Information
=====================================================
NPI Number | 1366320657
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CADANCE GARRETSON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/25/2025
-----------------------------------------------------
Last Update Date | 08/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 225 P.O. BOX BRENTON RD BAILEY HW
-----------------------------------------------------
City | BRENTON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 24818
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 681-250-6033
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 225
-----------------------------------------------------
City | BRENTON
-----------------------------------------------------
State | WV
-----------------------------------------------------
Zip | 24818-0225
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 374U00000X
-----------------------------------------------------
Taxonomy Name | Home Health Aide
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------