KYLER DAWN MAYBERRY NPI 1760132807

NPI Information

NPI: 1760132807
Provider Name: KYLER DAWN MAYBERRY
Classification: Peer Specialist - 175T00000X
Entity Type: Individual
Address:
3425 13TH ST
BAKER CITY, OR
ZIP 97814
Phone: (541) 523-7400
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Kyler Dawn Mayberry is a peer specialist in Baker City, OR. The provider is individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority. Kyler Dawn Mayberry NPI is 1760132807. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3425 13TH ST
BAKER CITY, OR
ZIP 97814-340
Phone: (541) 523-7400
Fax: (541) 523-4927

The enumeration date for this NPI number is 3/23/2022 and was last updated on 3/23/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	171M00000X	Case Manager/Care Coordinator		PENDING	OREGON	No
2	175T00000X	Peer Specialist		PENDING	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	A434555	OTHER	OREGON	DRIVERS LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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