Individual
AUTUMN BARE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1540 SPRING VALLEY DR, HUNTINGTON, WV 25704-9501
(304) 429-6741
Mailing address
215 KEITH ST, RACELAND, KY 41169-2108
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4050629
KY
Other
Enumeration date
06/22/2026
Last updated
06/22/2026
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