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General NPI Number Information
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NPI Number | 1831907047
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Entity Type | Individual
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Provider Name | TANYA RENEA ADKINS
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Gender | Female
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 355 BIG BRANCH RD
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City | WAYNE
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State | WV
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Zip | 25570-9417
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Country | US
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Telephone | 304-638-9165
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Fax |
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Provider Business Mailing Address
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Address Line | 355 BIG BRANCH RD
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City | WAYNE
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State | WV
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Zip | 25570-9417
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Country | US
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Telephone | 304-638-9165
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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 | 163WC1500X
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Taxonomy Name | Community Health Registered Nurse
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License Number | 64567
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License Number State | WV
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