Healthcare Provider Details

I. General information

NPI: 1053921338
Provider Name (Legal Business Name): KALEY MARIE MEYERS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 07/10/2023
Certification Date: 07/06/2023
Deactivation Date: 05/19/2023
Reactivation Date: 07/05/2023

III. Provider practice location address

2647 QUARRY VALLEY RD
COLUMBUS OH
43204-4972
US

IV. Provider business mailing address

2647 QUARRY VALLEY RD
COLUMBUS OH
43204-4972
US

V. Phone/Fax

Practice location:
  • Phone: 330-235-3139
  • Fax:
Mailing address:
  • Phone: 330-235-3139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code172A00000X
TaxonomyDriver
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: