Provider Demographics
NPI:1528741600
Name:SMILEY, MAKAYLA KIELE
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:KIELE
Last Name:SMILEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MAKAYLA
Other - Middle Name:KIELE
Other - Last Name:DAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:183 RIVERVIEW DR
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:WV
Mailing Address - Zip Code:25177-1694
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:183 RIVERVIEW DR
Practice Address - Street 2:
Practice Address - City:SAINT ALBANS
Practice Address - State:WV
Practice Address - Zip Code:25177-1694
Practice Address - Country:US
Practice Address - Phone:304-807-6721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-07
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program