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NPI 1912790478

NPI 1912790478 : CARLA CAIN : WAVERLY, WV

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General NPI Number Information
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    NPI Number           |    1912790478
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    Entity Type          |    Individual 
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    Provider Name        |    CARLA CAIN
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    Gender               |     
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Dates
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    Enumeration Date     |    05/27/2025
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    Last Update Date     |    05/27/2025
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Provider Practice Location Address
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    Address Line         |    2087 BULL CREEK RD 
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    City                 |    WAVERLY
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    State                |    WV
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    Zip                  |    26184-7100
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    Country              |    US
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    Telephone            |    304-916-8123
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2087 BULL CREEK RD 
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    City                 |    WAVERLY
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    State                |    WV
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    Zip                  |    26184-7100
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    Country              |    US
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    Telephone            |    
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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        |    374U00000X
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    Taxonomy Name        |    Home Health Aide
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    License Number       |    
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    License Number State |    
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