Provider Demographics
NPI:1932161395
Name:MCFADDEN, KAYLA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:MCFADDEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1554 OLD HWY 51N APT A4
Mailing Address - Street 2:
Mailing Address - City:ARBOR VITAE
Mailing Address - State:WV
Mailing Address - Zip Code:54568-9719
Mailing Address - Country:US
Mailing Address - Phone:715-356-6914
Mailing Address - Fax:
Practice Address - Street 1:215 SUNSET BLVD
Practice Address - Street 2:
Practice Address - City:ST.GERMAINE
Practice Address - State:WV
Practice Address - Zip Code:54558
Practice Address - Country:US
Practice Address - Phone:715-477-0821
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse