Individual
KELLI EAGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
209 LAKIN ST APT 3A, CHARLESTON, WV 25311-1247
(304) 543-0230
Mailing address
209 LAKIN ST APT 3A, CHARLESTON, WV 25311-1247
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
02/20/2025
Last updated
02/20/2025
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