Provider Demographics
NPI:1407621584
Name:GEISLER, KAYLA BROOKE (NP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:BROOKE
Last Name:GEISLER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WORTH CIR
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-4304
Mailing Address - Country:US
Mailing Address - Phone:423-914-1149
Mailing Address - Fax:
Practice Address - Street 1:2 WORTH CIR
Practice Address - Street 2:
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-4304
Practice Address - Country:US
Practice Address - Phone:423-914-1149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN34666363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily