Provider Demographics
NPI:1588644371
Name:CAYLOR, KIMBERLY A (CNM)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:A
Last Name:CAYLOR
Suffix:
Gender:F
Credentials:CNM
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Other - First Name:
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Mailing Address - Street 1:13700 ST FRANCIS BLVD
Mailing Address - Street 2:SUITE 510
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23114-3222
Mailing Address - Country:US
Mailing Address - Phone:804-423-8462
Mailing Address - Fax:804-423-8463
Practice Address - Street 1:13700 ST FRANCIS BLVD
Practice Address - Street 2:SUITE 510
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23114-3222
Practice Address - Country:US
Practice Address - Phone:804-423-8462
Practice Address - Fax:804-423-8463
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2016-08-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0024000010367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC09633OtherGROUP PTAN