Provider Demographics
NPI:1023359577
Name:STINSON, KAYLA R (NP-C)
Entity Type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:R
Last Name:STINSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1501 PIRTLE DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:IN
Mailing Address - Zip Code:47122-9109
Mailing Address - Country:US
Mailing Address - Phone:812-923-6200
Mailing Address - Fax:812-923-6204
Practice Address - Street 1:5300 STATE ROAD 64
Practice Address - Street 2:SUITE 103
Practice Address - City:GEORGETOWN
Practice Address - State:IN
Practice Address - Zip Code:47122-9178
Practice Address - Country:US
Practice Address - Phone:812-923-6200
Practice Address - Fax:812-923-6200
Is Sole Proprietor?:No
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN71004283A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner