Provider Demographics
NPI:1598483240
Name:NAIRN, MIKAYLA LAYNE
Entity Type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:LAYNE
Last Name:NAIRN
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 1:9429 EXCURSION DR
Mailing Address - Street 2:
Mailing Address - City:OAK POINT
Mailing Address - State:TX
Mailing Address - Zip Code:75068-1909
Mailing Address - Country:US
Mailing Address - Phone:972-754-5562
Mailing Address - Fax:
Practice Address - Street 1:900 JUNCTION DR
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5290
Practice Address - Country:US
Practice Address - Phone:469-675-3153
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX122653225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics