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General NPI Number Information
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NPI Number | 1407208770
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Entity Type | Individual
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Provider Name | KAYLEIGH NOLAN
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Gender | Female
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Dates
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Enumeration Date | 07/11/2016
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 1 MEDICAL CENTER DR RM 1265
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City | MORGANTOWN
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State | WV
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Zip | 26506-1200
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Country | US
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Telephone | 304-293-3600
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Fax |
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Provider Business Mailing Address
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Address Line | 625 LINCOLN AVE STE 209
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City | N CHARLEROI
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State | PA
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Zip | 15022-2451
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Country | US
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Telephone | 724-483-2159
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Fax | 724-489-4758
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1835
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License Number State | WV
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