MEDICARE: HEATHER J STOVER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator		WV

General Provider Information

NPI Number	:	1568398634
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER J STOVER

Provider Business Mailing Address
First Line	:	150 CARL WADE RD
Second Line	:
City	:	PRINCETON
State	:	WV
Zip	:	24739-3624
Country	:	US
Telephone Number	:	681-222-8810
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 CARL WADE RD
Second Line	:
City	:	PRINCETON
State	:	WV
Zip	:	24739-3624
Country	:	US
Telephone Number	:	681-222-8810
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/18/2026
Last Update Date	:	06/18/2026

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Directions to “ HEATHER J STOVER ” Practice Location

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