Provider Demographics
NPI:1144454596
Name:LABIER, KAYLA MARIE
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:LABIER
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 1:11635 US HIGHWAY 11
Mailing Address - Street 2:
Mailing Address - City:NORTH LAWRENCE
Mailing Address - State:NY
Mailing Address - Zip Code:12967-1533
Mailing Address - Country:US
Mailing Address - Phone:315-208-4078
Mailing Address - Fax:
Practice Address - Street 1:11635 US HIGHWAY 11
Practice Address - Street 2:
Practice Address - City:NORTH LAWRENCE
Practice Address - State:NY
Practice Address - Zip Code:12967-1533
Practice Address - Country:US
Practice Address - Phone:315-208-4078
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY294928164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse