Provider Demographics
NPI:1275121980
Name:MEYER, KAYLA (APRN- CNP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:APRN- CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4030 GILBERT AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3869
Mailing Address - Country:US
Mailing Address - Phone:713-261-6757
Mailing Address - Fax:
Practice Address - Street 1:273 E OVILLA RD STE 4
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154-2605
Practice Address - Country:US
Practice Address - Phone:972-617-6660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1016649363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics