Hollie Beth Blackburn

Individual provider Active NPI Community Health Worker · Gilbert, WV

NPI 1477147346 · NPPES record last updated Feb 22, 2021

Key facts

NPI
1477147346
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
83 Mitchell LN
Gilbert, WV 25621-9722
Phone
(304) 953-4475
NPI assigned
Feb 22, 2021
Sex
Female
Sole proprietor
Yes

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
Community Health Worker 172V00000X Yes

Addresses

Primary practice location

83 Mitchell LN
Gilbert, WV 25621-9722

Mailing address

PO Box 1752
Gilbert, WV 25621-1752
Phone (304) 953-4475

Other providers in Gilbert, WV

All providers in Gilbert, WV · Community Health Worker in West Virginia

Sources for this page

Verify at the official NPI Registry.