Provider Demographics
NPI:1225707912
Name:MCCALLISTER, KAYLA (MS, APRN-CNP, WHNP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MCCALLISTER
Suffix:
Gender:F
Credentials:MS, APRN-CNP, WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:682 ALLENBY DR
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-8777
Mailing Address - Country:US
Mailing Address - Phone:937-578-8944
Mailing Address - Fax:
Practice Address - Street 1:940 LONDON AVE
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-8036
Practice Address - Country:US
Practice Address - Phone:937-578-8944
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-07
Last Update Date:2021-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0027258363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health