Provider Demographics
NPI:1609660349
Name:BRACY, KALEYA NICOLE
Entity type:Individual
Prefix:
First Name:KALEYA
Middle Name:NICOLE
Last Name:BRACY
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12306 SCOTT GRANT RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95901-9599
Mailing Address - Country:US
Mailing Address - Phone:209-275-3281
Mailing Address - Fax:
Practice Address - Street 1:12306 SCOTT GRANT RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:CA
Practice Address - Zip Code:95901-9599
Practice Address - Country:US
Practice Address - Phone:209-275-3281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula