Provider Demographics
NPI:1417681669
Name:TROCKMAN, KAYLA (PA)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:TROCKMAN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 TERIS WAY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MA
Mailing Address - Zip Code:02038-3206
Mailing Address - Country:US
Mailing Address - Phone:774-571-9928
Mailing Address - Fax:
Practice Address - Street 1:20 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:MA
Practice Address - Zip Code:01757-3042
Practice Address - Country:US
Practice Address - Phone:508-488-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-13
Last Update Date:2022-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant