Provider Demographics
NPI:1881341238
Name:BYERLY, CAILIN NICOLE
Entity type:Individual
Prefix:
First Name:CAILIN
Middle Name:NICOLE
Last Name:BYERLY
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 1:82 TOWN RUN RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMOUNT CITY
Mailing Address - State:PA
Mailing Address - Zip Code:16224-1502
Mailing Address - Country:US
Mailing Address - Phone:833-684-1904
Mailing Address - Fax:
Practice Address - Street 1:82 TOWN RUN RD
Practice Address - Street 2:
Practice Address - City:FAIRMOUNT CITY
Practice Address - State:PA
Practice Address - Zip Code:16224-1502
Practice Address - Country:US
Practice Address - Phone:833-684-1904
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-06
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA063368363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical