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NPI Code Detail

MEDICARE: KAIYA L MAYNE

MEDICARE: KAIYA L MAYNE
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
1163WH0200XHome Health Registered Nurse76814WV
2374U00000XHome Health Aide

General Provider Information

NPI Number : 1104428895
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAIYA L MAYNE
Provider Business Mailing Address
First Line : 3901 BRISCOE RUN RD
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-0002
Country : US
Telephone Number : 304-422-0776
Fax Number :
Provider Business Practice Location Address
First Line : 3901 BRISCOE RUN RD
Second Line :
City : PARKERSBURG
State : WV
Zip : 26104-0002
Country : US
Telephone Number : 304-422-0776
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/09/2020
Last Update Date : 12/22/2020

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Directions to “ KAIYA L MAYNE ” Practice Location

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