Provider Demographics
NPI:1306730494
Name:WEIKLE, KATHY ANN
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:ANN
Last Name:WEIKLE
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 1:4483 PRENTER RD
Mailing Address - Street 2:
Mailing Address - City:SETH
Mailing Address - State:WV
Mailing Address - Zip Code:25181-9614
Mailing Address - Country:US
Mailing Address - Phone:304-837-3292
Mailing Address - Fax:
Practice Address - Street 1:4483 PRENTER RD
Practice Address - Street 2:
Practice Address - City:SETH
Practice Address - State:WV
Practice Address - Zip Code:25181-9614
Practice Address - Country:US
Practice Address - Phone:304-837-3292
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant