Provider Demographics
NPI:1134933435
Name:BYGRAVE, MARCIA KAYE (LPN)
Entity type:Individual
Prefix:
First Name:MARCIA
Middle Name:KAYE
Last Name:BYGRAVE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5312 SUMMER PLACE PKWY
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35244-6001
Mailing Address - Country:US
Mailing Address - Phone:205-534-1789
Mailing Address - Fax:
Practice Address - Street 1:5312 SUMMER PLACE PKWY
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35244-6001
Practice Address - Country:US
Practice Address - Phone:205-534-1789
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-05
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2-039177164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse