# HOLISTIC, INC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811405616
- **Authorized official:** MR. SHAWN ROBERT BLANKENSHIP NURSE PRACTITIONER (OWNER)
- **Authorized official phone:** (304) 553-1576

## Contact information

- **Practice address:** 4815 MACCORKLE AVE SE, CHARLESTON, WV 25304-1948
- **Practice address phone:** (681) 265-1693
- **Practice address fax:** (681) 265-0990
- **Mailing address:** 7 ANCHORS WAY, WINFIELD, WV 25213-9786
- **Mailing address phone:** (304) 553-1576

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | WV | Yes |
| 261QM2500X | Medical Specialty Clinic/Center | — | WV | — |

## Other

- **Enumeration date:** 01/15/2018
- **Last updated:** 08/22/2023