Provider Demographics
NPI:1023612819
Name:PYATT, CAYLIN ELIZABETH
Entity type:Individual
Prefix:
First Name:CAYLIN
Middle Name:ELIZABETH
Last Name:PYATT
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 1:16202 CLAY HWY
Mailing Address - Street 2:
Mailing Address - City:LIZEMORES
Mailing Address - State:WV
Mailing Address - Zip Code:25125-8058
Mailing Address - Country:US
Mailing Address - Phone:304-632-4160
Mailing Address - Fax:
Practice Address - Street 1:15 BANK ST
Practice Address - Street 2:
Practice Address - City:CLAY
Practice Address - State:WV
Practice Address - Zip Code:25043
Practice Address - Country:US
Practice Address - Phone:304-587-9992
Practice Address - Fax:304-587-9993
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant