Provider Demographics
NPI:1093199739
Name:ROWLAND, KAYLA (AGPCNP-BC)
Entity Type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:
Last Name:ROWLAND
Suffix:
Gender:F
Credentials:AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:144 BOYLAN LN N
Mailing Address - Street 2:
Mailing Address - City:BLUE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11715-1806
Mailing Address - Country:US
Mailing Address - Phone:631-739-4875
Mailing Address - Fax:
Practice Address - Street 1:21 MURRAY ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-2239
Practice Address - Country:US
Practice Address - Phone:646-701-0021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-13
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY658389163WM0705X
NYF307598363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical