Provider Demographics
NPI:1447145628
Name:BRITTINGHAM, KAYLEN
Entity type:Individual
Prefix:
First Name:KAYLEN
Middle Name:
Last Name:BRITTINGHAM
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 1:639 DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:RAVENSWOOD
Mailing Address - State:WV
Mailing Address - Zip Code:26164-1209
Mailing Address - Country:US
Mailing Address - Phone:304-531-8391
Mailing Address - Fax:
Practice Address - Street 1:639 DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:RAVENSWOOD
Practice Address - State:WV
Practice Address - Zip Code:26164-1209
Practice Address - Country:US
Practice Address - Phone:304-531-8391
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant