Provider Demographics
NPI:1659971067
Name:KAYLOR, MARY E (RN, CHC)
Entity Type:Individual
Prefix:MRS
First Name:MARY
Middle Name:E
Last Name:KAYLOR
Suffix:
Gender:F
Credentials:RN, CHC
Other - Prefix:MRS
Other - First Name:BETH
Other - Middle Name:
Other - Last Name:KAYLOR
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN, CHC
Mailing Address - Street 1:9446 E BRAINERD RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-3404
Mailing Address - Country:US
Mailing Address - Phone:423-883-4136
Mailing Address - Fax:
Practice Address - Street 1:9446 E BRAINERD RD
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37421-3404
Practice Address - Country:US
Practice Address - Phone:423-883-4136
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174H00000X
TN87462163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No174H00000XOther Service ProvidersHealth Educator