Amanda Spaulding

Individual provider Active NPI Community Health Worker · Kermit, WV

NPI 1942895891 · NPPES record last updated Mar 3, 2021

Key facts

NPI
1942895891
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Worker 172V00000X
Practice address
1861 Hidden Valley
Trailer 2
Kermit, WV 25674
Phone
(304) 393-9255
NPI assigned
Mar 3, 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

1861 Hidden Valley
Trailer 2
Kermit, WV 25674

Mailing address

PO Box 186
Kermit, WV 25674-0186
Phone (304) 393-9255

Other providers in Kermit, WV

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

Sources for this page

Verify at the official NPI Registry.