Holly Deanna Cork, RN

Individual provider Active NPI Home Health Registered Nurse · Clarksburg, WV

NPI 1194434845 · NPPES record last updated Nov 22, 2022

Key facts

NPI
1194434845
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Registered Nurse 163WH0200X
License
75607 (WV)
Practice address
2673 Davisson Run Rd
Clarksburg, WV 26301-6838
Phone
(304) 624-2424
NPI assigned
Nov 22, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
75607WVMDHome Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Registered Nurse 163WH0200X 75607 WV Yes

Addresses

Primary practice location

2673 Davisson Run Rd
Clarksburg, WV 26301-6838

Mailing address

2673 Davisson Run Rd
Clarksburg, WV 26301-6838
Phone (304) 624-2424

Other providers in Clarksburg, WV

All providers in Clarksburg, WV · Home Health Registered Nurse in West Virginia

Sources for this page

Verify at the official NPI Registry.