Amanda Buckhannon
Individual provider Active NPI Community Health Worker · Flatwoods, WV
NPI 1982280236 · NPPES record last updated Mar 18, 2021
Key facts
- NPI
- 1982280236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community Health Worker 172V00000X
- Practice address
- 196 Johnson Lane
Flatwoods, WV 26621 - Phone
- (304) 701-1100
- NPI assigned
- Mar 18, 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Community Health Worker | 172V00000X | Yes |
Addresses
Primary practice location
196 Johnson Lane
Flatwoods, WV 26621
Mailing address
224 Stone Run Road
Flatwoods, WV 26621
Other providers in Flatwoods, WV
- Sally Marie Bender
- Community Care of West Virginia, Inc.
- Kylie Metz
- Kayla Morrison
- Kelly Peitt
- Carissa Danielle Queen
All providers in Flatwoods, WV · Community Health Worker in West Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 18, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.