Provider Demographics
NPI:1134948755
Name:KAYS, MARIKO (RN)
Entity type:Individual
Prefix:
First Name:MARIKO
Middle Name:
Last Name:KAYS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MARIKO
Other - Middle Name:E
Other - Last Name:BAIRD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6176 S SLIPSTREAM CIR
Mailing Address - Street 2:
Mailing Address - City:WASILLA
Mailing Address - State:AK
Mailing Address - Zip Code:99623-8718
Mailing Address - Country:US
Mailing Address - Phone:907-952-1036
Mailing Address - Fax:
Practice Address - Street 1:3223 E PALMER WASILLA HWY STE 3
Practice Address - Street 2:
Practice Address - City:WASILLA
Practice Address - State:AK
Practice Address - Zip Code:99654-7277
Practice Address - Country:US
Practice Address - Phone:907-952-1036
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-09
Last Update Date:2024-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK170142163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse