Provider Demographics
NPI:1346748555
Name:SURINA, KAYLI (PA-C)
Entity Type:Individual
Prefix:
First Name:KAYLI
Middle Name:
Last Name:SURINA
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAYLI
Other - Middle Name:
Other - Last Name:BURRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:901 RANCHO LN STE 135
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-3826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 RANCHO LN STE 135
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-3826
Practice Address - Country:US
Practice Address - Phone:602-383-1958
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-23
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant