Healthcare Provider Details

I. General information

NPI: 1275354235
Provider Name (Legal Business Name): KAYLA MAGRELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

295 FRISBY AVE
BARBERTON OH
44203-4217
US

IV. Provider business mailing address

295 FRISBY AVE
BARBERTON OH
44203-4217
US

V. Phone/Fax

Practice location:
  • Phone: 330-622-3636
  • Fax:
Mailing address:
  • Phone: 330-622-3636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number478675
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: