Healthcare Provider Details

I. General information

NPI: 1841165966
Provider Name (Legal Business Name): JAKYRA SCAIFE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2025
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

715 ROLLERTON RD APT 306
CHARLOTTE NC
28205-1183
US

IV. Provider business mailing address

715 ROLLERTON RD APT 306
CHARLOTTE NC
28205-1183
US

V. Phone/Fax

Practice location:
  • Phone: 870-514-4554
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WL0100X
TaxonomyLactation Consultant (Registered Nurse)
License Number381797
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: