Provider Demographics
NPI:1184515496
Name:KINGMAN, KAII ACHLEI
Entity type:Individual
Prefix:
First Name:KAII
Middle Name:ACHLEI
Last Name:KINGMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67 E HAMPSHIRE ST
Mailing Address - Street 2:
Mailing Address - City:PIEDMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26750-1214
Mailing Address - Country:US
Mailing Address - Phone:304-790-5571
Mailing Address - Fax:
Practice Address - Street 1:67 E HAMPSHIRE ST
Practice Address - Street 2:
Practice Address - City:PIEDMONT
Practice Address - State:WV
Practice Address - Zip Code:26750-1214
Practice Address - Country:US
Practice Address - Phone:304-790-5571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant