Provider Demographics
NPI:1891498887
Name:ADKINS, REBECCA SUE
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:SUE
Last Name:ADKINS
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 1:2830 SERVIA ELMIRA RD
Mailing Address - Street 2:
Mailing Address - City:DUCK
Mailing Address - State:WV
Mailing Address - Zip Code:25063-9158
Mailing Address - Country:US
Mailing Address - Phone:681-422-2814
Mailing Address - Fax:
Practice Address - Street 1:2830 SERVIA ELMIRA RD
Practice Address - Street 2:
Practice Address - City:DUCK
Practice Address - State:WV
Practice Address - Zip Code:25063-9158
Practice Address - Country:US
Practice Address - Phone:681-422-2814
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-27
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant