Individual
AMANDA BLACKBURN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
PO BOX 306, LENORE, WV 25676-0306
(304) 836-5505
Mailing address
PO BOX 306, LENORE, WV 25676-0306
(304) 836-5505
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
12/16/2020
Last updated
08/15/2025
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