Provider Demographics
NPI:1164144184
Name:LAYFIELD, CAROL L
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:L
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 1:1052 SILVER RUN RD
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:WV
Mailing Address - Zip Code:26337-6706
Mailing Address - Country:US
Mailing Address - Phone:304-481-0726
Mailing Address - Fax:
Practice Address - Street 1:1052 SILVER RUN RD
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:WV
Practice Address - Zip Code:26337-6706
Practice Address - Country:US
Practice Address - Phone:304-481-0726
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-15
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV24078164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV24078OtherLPN
WV24078Medicaid