MEDICARE: KAYLEIGH MOULTON

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
1	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1366334948
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLEIGH MOULTON

Provider Business Mailing Address
First Line	:	4809 N TULSA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2243
Country	:	US
Telephone Number	:	940-882-2372
Fax Number	:

Provider Business Practice Location Address
First Line	:	4809 N TULSA AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-2243
Country	:	US
Telephone Number	:	940-882-2372
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2025
Last Update Date	:	07/17/2025

Similar Medicare Providers

1235132317 — PRAKASH D ADAWADKAR M.D.
Practice Location Address:

4201 DALE BLVD
DALE CITY, VA
22193-2243

Practice Phone: 703-670-0300
Practice Fax: 703-670-6759

1144336686 — MARGARET HARVELL SOLES CCC-SLP
Practice Location Address:

229 TRULUCK ST
LAKE CITY, SC
29560-2243

Practice Phone: 843-699-9006
Practice Fax:

1730245010 — FRONTIER HEALTH
Practice Location Address:

2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN
37601-2872

Practice Phone: 423-928-5627
Practice Fax: 423-928-4222

1104940238 — MS. CAITLIN ANNE BARTHOLOMEW BACHELOR OF SCIENCE
Practice Location Address:

2243 EDDIE WILLIAMS DRIVE
JOHNSON CITY, TN
37601

Practice Phone: 423-434-4638
Practice Fax:

1396869426 — MRS. CAROLINE REAGAN HOLLAND MASTER OF SCIENCE
Practice Location Address:

2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN
37601

Practice Phone: 423-928-5627
Practice Fax: 423-928-4222

1841314622 — KELLY BROOKE MITCHELL ASSOCIATE DEGREE INT
Practice Location Address:

2243 EDDIE WILLIAMS RD
JOHNSON CITY, TN
37601

Practice Phone: 423-434-0447
Practice Fax: 423-434-0880

Directions to “ KAYLEIGH MOULTON ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.