Melinda Sprouse

Individual provider Active NPI Community Health Worker · Waverly, WV

NPI 1659958825 · NPPES record last updated Mar 25, 2021

Key facts

NPI
1659958825
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
750 Isaac Fork Rd
Waverly, WV 26184-3544
Phone
(304) 679-5639
NPI assigned
Mar 25, 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

750 Isaac Fork Rd
Waverly, WV 26184-3544

Mailing address

750 Isaac Fork Rd
Waverly, WV 26184-3544
Phone (304) 679-5639

Other providers in Waverly, WV

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

Sources for this page

Verify at the official NPI Registry.