Healthcare Provider Details

I. General information

NPI: 1679496673
Provider Name (Legal Business Name): MS. KAYLEIGH JEAN AMMONS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 OLD SOURWOOD ACRES
SYLVA NC
28779-8514
US

IV. Provider business mailing address

67 OLD SOURWOOD ACRES
SYLVA NC
28779-8514
US

V. Phone/Fax

Practice location:
  • Phone: 828-399-9869
  • Fax:
Mailing address:
  • Phone: 828-399-9869
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: