Most Relevant Information
Provider Data
| NPI Number: | 1003423997 |
| Provider Name: | KAYLA NIKKOLE ABERNATHY |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 09/25/2020 |
| Last Updated: | 05/09/2022 |
Provider Practice Location
828 LEE AVE
MADISON
WV
251301505
Practice Location Phone/Fax
| Phone: | 3042394583 |
| Fax: |
Provider Mailing Location
828 LEE AVE
MADISON
WV
251301505
Provider Mailing Phone/Fax
| Phone: | 3042394583 |
| Fax: |