Provider Demographics
NPI:1376312355
Name:HOOPER, KAYLA RAYE
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:RAYE
Last Name:HOOPER
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:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45740-0193
Mailing Address - Country:US
Mailing Address - Phone:740-677-9383
Mailing Address - Fax:
Practice Address - Street 1:3 S 6TH ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:OH
Practice Address - Zip Code:45740-2504
Practice Address - Country:US
Practice Address - Phone:740-677-9383
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-01
Last Update Date:2024-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care