Provider Demographics
NPI:1366017956
Name:DAVIS, KAYLA DANIELLE (CRNA)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:DANIELLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:356 ROXALANA HILLS DR
Mailing Address - Street 2:
Mailing Address - City:DUNBAR
Mailing Address - State:WV
Mailing Address - Zip Code:25064-1924
Mailing Address - Country:US
Mailing Address - Phone:304-952-8842
Mailing Address - Fax:
Practice Address - Street 1:356 ROXALANA HILLS DR
Practice Address - Street 2:
Practice Address - City:DUNBAR
Practice Address - State:WV
Practice Address - Zip Code:25064-1924
Practice Address - Country:US
Practice Address - Phone:304-952-8842
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-25
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV132351367500000X
WV109976367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered