Provider Demographics
NPI:1164045746
Name:JOHNSON, KAYLA WORK (DNP)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:WORK
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 CANTERBURY RD
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:NC
Mailing Address - Zip Code:27577-4861
Mailing Address - Country:US
Mailing Address - Phone:919-934-5149
Mailing Address - Fax:
Practice Address - Street 1:410 CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:NC
Practice Address - Zip Code:27577-4861
Practice Address - Country:US
Practice Address - Phone:919-934-5149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-18
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016503363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily