Provider Demographics
NPI:1063103588
Name:CASEY, KAYLA RAE
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:RAE
Last Name:CASEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4466 VERDON ST UNIT 1173
Mailing Address - Street 2:
Mailing Address - City:NORTH LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89031-4435
Mailing Address - Country:US
Mailing Address - Phone:346-644-1176
Mailing Address - Fax:
Practice Address - Street 1:4466 VERDON ST UNIT 1173
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89031-4435
Practice Address - Country:US
Practice Address - Phone:346-644-1176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-16
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant