Provider Demographics
NPI:1750955852
Name:ADAMS, KATHRYN ASHLEY
Entity type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ASHLEY
Last Name:ADAMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 MACKENZIE LN
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-7528
Mailing Address - Country:US
Mailing Address - Phone:240-435-6491
Mailing Address - Fax:
Practice Address - Street 1:31 MACKENZIE LN
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-7528
Practice Address - Country:US
Practice Address - Phone:240-435-6491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-14
Last Update Date:2021-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant