Provider Demographics
NPI:1154064517
Name:MYREN, KAYLA (NP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MYREN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1601 E 19TH AVE STE 6000
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-1293
Mailing Address - Country:US
Mailing Address - Phone:303-861-7001
Mailing Address - Fax:
Practice Address - Street 1:1601 E 19TH AVE STE 6000
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80218-1293
Practice Address - Country:US
Practice Address - Phone:303-861-7001
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-14
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0997508-NP207Q00000X
CO997508363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine