Ashley Nicole Black

Individual provider Active NPI Case Manager/Care Coordinator · Kenova, WV

NPI 1265043582 · NPPES record last updated Aug 11, 2020

Key facts

NPI
1265043582
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1401 Chestnut St
Kenova, WV 25530-1235
Phone
(304) 453-2800
Fax
(304) 453-2820
NPI assigned
Aug 11, 2020
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1401 Chestnut St
Kenova, WV 25530-1235

Mailing address

1401 Chestnut St
Kenova, WV 25530-1235
Phone (304) 453-2800

Other identifiers

IdentifierTypeStateIssuer
3810024363MedicaidWV

Other providers in Kenova, WV

All providers in Kenova, WV · Case Manager/Care Coordinator in West Virginia

Sources for this page

Verify at the official NPI Registry.