Provider Demographics
NPI:1427541242
Name:GRIFFIN, KAYLAR MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:KAYLAR
Middle Name:MICHELLE
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:PROF
Other - First Name:KAYLAR
Other - Middle Name:MICHELLE
Other - Last Name:GRIFFIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:179 GANN BRANCH RD
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76549-3862
Mailing Address - Country:US
Mailing Address - Phone:254-987-0405
Mailing Address - Fax:254-200-4486
Practice Address - Street 1:179 GANN BRANCH RD
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76549-3862
Practice Address - Country:US
Practice Address - Phone:254-987-0405
Practice Address - Fax:254-200-4486
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-07
Last Update Date:2018-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX618163163WC1500X, 163WC0400X, 163WC1600X, 163WN1003X, 163WW0101X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WN1003XNursing Service ProvidersRegistered NurseNutrition Support
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory