Provider Demographics
NPI:1306212675
Name:ZUMO, KAYLA LANGLOIS (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:LANGLOIS
Last Name:ZUMO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:LANGLOIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:7777 HENNESSY BLVD STE 8001
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70808-4300
Mailing Address - Country:US
Mailing Address - Phone:225-490-7224
Mailing Address - Fax:225-490-7223
Practice Address - Street 1:7777 HENNESSY BLVD STE 8001
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70808
Practice Address - Country:US
Practice Address - Phone:225-490-7224
Practice Address - Fax:225-490-7223
Is Sole Proprietor?:No
Enumeration Date:2015-08-20
Last Update Date:2021-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2409581Medicaid
LA456778YH83Medicare UPIN