Healthcare Provider Details

I. General information

NPI: 1972425460
Provider Name (Legal Business Name): KAYLA FILLER
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 GASTON AVE
FAIRMONT WV
26554-0178
US

IV. Provider business mailing address

125 HARLEE ST
FAIRMONT WV
26554-4399
US

V. Phone/Fax

Practice location:
  • Phone: 681-404-7302
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: