Provider Demographics
NPI:1730648742
Name:GAINER, KAYLA N
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:N
Last Name:GAINER
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 1:219 MAPLE LN
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-7279
Mailing Address - Country:US
Mailing Address - Phone:304-940-5033
Mailing Address - Fax:
Practice Address - Street 1:219 MAPLE LN
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-7279
Practice Address - Country:US
Practice Address - Phone:304-940-5033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer