Healthcare Provider Details

I. General information

NPI: 1750217709
Provider Name (Legal Business Name): KAYLEE SCOTT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 HARPER RD
BECKLEY WV
25801-3373
US

IV. Provider business mailing address

110 CENTRAL AVE
HINTON WV
25951-2610
US

V. Phone/Fax

Practice location:
  • Phone: 681-251-8570
  • Fax:
Mailing address:
  • Phone: 304-250-8775
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number109159
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: