Provider Demographics
NPI:1164088001
Name:MURRAY, KAYLA (PA-C)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MURRAY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 INNOVATION DR STE 101
Mailing Address - Street 2:
Mailing Address - City:SLIPPERY ROCK
Mailing Address - State:PA
Mailing Address - Zip Code:16057-2468
Mailing Address - Country:US
Mailing Address - Phone:724-794-4023
Mailing Address - Fax:724-794-3675
Practice Address - Street 1:100 INNOVATION DR STE 101
Practice Address - Street 2:
Practice Address - City:SLIPPERY ROCK
Practice Address - State:PA
Practice Address - Zip Code:16057-2468
Practice Address - Country:US
Practice Address - Phone:724-794-4023
Practice Address - Fax:724-794-3675
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060701363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant