Healthcare Provider Details

I. General information

NPI: 1003606195
Provider Name (Legal Business Name): KAYLEE WORD RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2025
Last Update Date: 05/12/2025
Certification Date: 05/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5300 MEDFORD DR
HOOVER AL
35244-2108
US

IV. Provider business mailing address

3021 CLAIRMONT AVE S APT 6
BIRMINGHAM AL
35205-1140
US

V. Phone/Fax

Practice location:
  • Phone: 205-820-8416
  • Fax:
Mailing address:
  • Phone: 256-483-2943
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number1-186059
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: