Healthcare Provider Details

I. General information

NPI: 1891648705
Provider Name (Legal Business Name): MRS. CAITLYN SAHARRA KINCAID
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. CAITLYN SAHARRA HICKS

II. Dates (important events)

Enumeration Date: 02/19/2026
Last Update Date: 02/19/2026
Certification Date: 02/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 N LINDSEY AVE
MIDWAY WV
25878
US

IV. Provider business mailing address

PO BOX 177
SOPHIA WV
25921-0177
US

V. Phone/Fax

Practice location:
  • Phone: 304-880-8320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: