Provider Demographics
NPI:1891496824
Name:CAFFEY, JAYLA MARIE
Entity type:Individual
Prefix:
First Name:JAYLA
Middle Name:MARIE
Last Name:CAFFEY
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 1:2401 TUCKASEEGEE RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-4058
Mailing Address - Country:US
Mailing Address - Phone:256-541-8582
Mailing Address - Fax:
Practice Address - Street 1:2401 TUCKASEEGEE RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-4058
Practice Address - Country:US
Practice Address - Phone:704-409-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-16
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001014649363A00000X
2255A2300X2255A2300X
2279P1005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No2279P1005XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredPulmonary Rehabilitation