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NPI Code Detail

MEDICARE: KAILEY JOHNSON

MEDICARE:   KAILEY  JOHNSON
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
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1417808536
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAILEY JOHNSON
Provider Business Mailing Address
First Line : 360 MAIN ST
Second Line :
City : HAMLIN
State : WV
Zip : 25523-1412
Country : US
Telephone Number : 304-824-3448
Fax Number :
Provider Business Practice Location Address
First Line : 360 MAIN ST
Second Line :
City : HAMLIN
State : WV
Zip : 25523-1412
Country : US
Telephone Number : 304-824-3448
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2026
Last Update Date : 02/05/2026

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Directions to “ KAILEY JOHNSON ” Practice Location

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