MEDICARE: MRS. KYRA LOY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	103244	WV

General Provider Information

NPI Number	:	1073371928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KYRA LOY

Provider Business Mailing Address
First Line	:	907 MEADOW HTS
Second Line	:
City	:	PADEN CITY
State	:	WV
Zip	:	26159-1925
Country	:	US
Telephone Number	:	304-771-6527
Fax Number	:

Provider Business Practice Location Address
First Line	:	299 1/2 N STATE ROUTE 2
Second Line	:
City	:	NEW MARTINSVILLE
State	:	WV
Zip	:	26155-2243
Country	:	US
Telephone Number	:	304-455-0350
Fax Number	:	304-455-1512

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2024
Last Update Date	:	03/06/2024

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