# KADEIDRE LA'TRELL GAYMON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1891460853
- **Gender:** F

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163W00000X | Registered Nurse | 249257 | SC | — |
| 163WC0200X | Critical Care Medicine Registered Nurse | 249257 | SC | Yes |
| 163WH0200X | Home Health Registered Nurse | 249257 | SC | — |
| 163WW0000X | Wound Care Registered Nurse | 249257 | SC | — |

## Other

- **Enumeration date:** 08/11/2021
- **Last updated:** 08/11/2021