Healthcare Provider Details

I. General information

NPI: 1316865835
Provider Name (Legal Business Name): MRS. KAILEY ANN YEAGER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 BROOKEDGE DR
HAMLIN NY
14464-9360
US

IV. Provider business mailing address

1322 BROOKEDGE DR
HAMLIN NY
14464-9360
US

V. Phone/Fax

Practice location:
  • Phone: 585-955-3178
  • Fax:
Mailing address:
  • Phone: 585-955-3178
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374J00000X
TaxonomyDoula
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: