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NPI Code Detail

MEDICARE: KAYLA MICHELLE ROE

MEDICARE:   KAYLA MICHELLE ROE
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner121993WV

General Provider Information

NPI Number : 1922811363
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA MICHELLE ROE
Provider Business Mailing Address
First Line : 104 ALEX LN
Second Line :
City : CHARLESTON
State : WV
Zip : 25304-2952
Country : US
Telephone Number : 304-734-2040
Fax Number : 304-734-2047
Provider Business Practice Location Address
First Line : 303 OHIO AVE
Second Line :
City : CHARLESTON
State : WV
Zip : 25302-2212
Country : US
Telephone Number : 681-205-8701
Fax Number : 833-428-4794
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/29/2025
Last Update Date : 12/03/2025

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Directions to “ KAYLA MICHELLE ROE ” Practice Location

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