Provider Demographics
NPI:1023726551
Name:ADAMS, KELLI RENEE (HHA)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:RENEE
Last Name:ADAMS
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:69 MAZE PLZ
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH
Mailing Address - State:WV
Mailing Address - Zip Code:26143-5127
Mailing Address - Country:US
Mailing Address - Phone:304-275-5001
Mailing Address - Fax:
Practice Address - Street 1:69 MAZE PLZ
Practice Address - Street 2:
Practice Address - City:ELIZABETH
Practice Address - State:WV
Practice Address - Zip Code:26143-5127
Practice Address - Country:US
Practice Address - Phone:304-275-5001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-14
Last Update Date:2022-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide