Provider Demographics
NPI:1891575148
Name:SALYERS, BROOKELYN DEANNA LEIGH
Entity Type:Individual
Prefix:
First Name:BROOKELYN
Middle Name:DEANNA LEIGH
Last Name:SALYERS
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 1:37 DOUGLAS BR
Mailing Address - Street 2:
Mailing Address - City:HARTS
Mailing Address - State:WV
Mailing Address - Zip Code:25524-7025
Mailing Address - Country:US
Mailing Address - Phone:304-687-4295
Mailing Address - Fax:
Practice Address - Street 1:37 DOUGLAS BR
Practice Address - Street 2:
Practice Address - City:HARTS
Practice Address - State:WV
Practice Address - Zip Code:25524-7025
Practice Address - Country:US
Practice Address - Phone:304-687-4295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-04
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant