Provider Demographics
NPI:1508545500
Name:MCCAUSLEY, KILEY
Entity Type:Individual
Prefix:
First Name:KILEY
Middle Name:
Last Name:MCCAUSLEY
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 1:15 STEPHENS DR
Mailing Address - Street 2:
Mailing Address - City:MOOREFIELD
Mailing Address - State:WV
Mailing Address - Zip Code:26836-9071
Mailing Address - Country:US
Mailing Address - Phone:304-703-7925
Mailing Address - Fax:
Practice Address - Street 1:15 STEPHENS DR
Practice Address - Street 2:
Practice Address - City:MOOREFIELD
Practice Address - State:WV
Practice Address - Zip Code:26836-9071
Practice Address - Country:US
Practice Address - Phone:304-703-7925
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-17
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant