Provider Demographics
NPI:1255076006
Name:SMITH, KAYLA HOPE
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:HOPE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:HOPE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5379 HUNTERS FORK RD
Mailing Address - Street 2:
Mailing Address - City:BELINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:26250-8407
Mailing Address - Country:US
Mailing Address - Phone:304-621-3931
Mailing Address - Fax:
Practice Address - Street 1:5379 HUNTERS FORK RD
Practice Address - Street 2:
Practice Address - City:BELINGTON
Practice Address - State:WV
Practice Address - Zip Code:26250-8407
Practice Address - Country:US
Practice Address - Phone:304-621-3931
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant