Healthcare Provider Details

I. General information

NPI: 1629936455
Provider Name (Legal Business Name): KAYSIE MARKLAND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3975 EMBASSY PKWY STE 3
FAIRLAWN OH
44333-8320
US

IV. Provider business mailing address

3975 EMBASSY PKWY STE 3
FAIRLAWN OH
44333-8320
US

V. Phone/Fax

Practice location:
  • Phone: 330-668-6789
  • Fax:
Mailing address:
  • Phone: 330-668-6789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0040546
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: