Provider Demographics
NPI:1093270365
Name:LAYFIELD, KAYSE DEANN
Entity Type:Individual
Prefix:
First Name:KAYSE
Middle Name:DEANN
Last Name:LAYFIELD
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 1:2050 WAGON WHEEL RD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:GA
Mailing Address - Zip Code:31647-3404
Mailing Address - Country:US
Mailing Address - Phone:229-392-3898
Mailing Address - Fax:
Practice Address - Street 1:2050 WAGON WHEEL RD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:GA
Practice Address - Zip Code:31647-3404
Practice Address - Country:US
Practice Address - Phone:229-392-3898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor