Healthcare Provider Details

I. General information

NPI: 1811884380
Provider Name (Legal Business Name): NAKKIA T AYERS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3106 RUTH ST
CHARLESTON WV
25302-4528
US

IV. Provider business mailing address

3106 RUTH ST
CHARLESTON WV
25302-4528
US

V. Phone/Fax

Practice location:
  • Phone: 304-419-3571
  • Fax: 304-419-3571
Mailing address:
  • Phone: 304-419-3571
  • Fax: 304-419-3571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number109912
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: