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NPI Code Detail

MEDICARE: KAYLEIGH BROOKE CLEEK RN

MEDICARE: KAYLEIGH BROOKE CLEEK RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WC0200XCritical Care Medicine Registered Nurse109233WV

General Provider Information

NPI Number : 1093658163
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLEIGH BROOKE CLEEK RN
Provider Business Mailing Address
First Line : 114 LINDEN LN
Second Line :
City : CULLODEN
State : WV
Zip : 25510-9646
Country : US
Telephone Number : 304-840-6461
Fax Number :
Provider Business Practice Location Address
First Line : 4605 MACCORKLE AVE SW
Second Line :
City : SOUTH CHARLESTON
State : WV
Zip : 25309-1398
Country : US
Telephone Number : 304-840-6461
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/13/2026
Last Update Date : 04/13/2026

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