Provider Demographics
NPI:1093241580
Name:MCMASTER, KAYLA (APRN, CNM)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MCMASTER
Suffix:
Gender:F
Credentials:APRN, CNM
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:KOELLING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3268 HOSPITAL DR STE B
Mailing Address - Street 2:
Mailing Address - City:JUNEAU
Mailing Address - State:AK
Mailing Address - Zip Code:99801-7800
Mailing Address - Country:US
Mailing Address - Phone:907-586-1717
Mailing Address - Fax:
Practice Address - Street 1:3268 HOSPITAL DR STE B
Practice Address - Street 2:
Practice Address - City:JUNEAU
Practice Address - State:AK
Practice Address - Zip Code:99801
Practice Address - Country:US
Practice Address - Phone:907-586-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-03
Last Update Date:2019-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKNURR31988163W00000X
AK119983367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
AK1692594Medicaid