Healthcare Provider Details

I. General information

NPI: 1548972508
Provider Name (Legal Business Name): KAYLA KRISTINE MEADE APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2022
Last Update Date: 06/24/2025
Certification Date: 06/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 1ST AVE STE 210
HUNTINGTON WV
25702-1241
US

IV. Provider business mailing address

3075 US ROUTE 60
HUNTINGTON WV
25705-8859
US

V. Phone/Fax

Practice location:
  • Phone: 304-525-7246
  • Fax:
Mailing address:
  • Phone: 304-528-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number115140
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: