Provider Demographics
NPI:1497247258
Name:FERRELL, KAYLA GREEN (MS, ATC, DPT)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:GREEN
Last Name:FERRELL
Suffix:
Gender:F
Credentials:MS, ATC, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7521 VIRGINIA OAKS DR STE 240
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-3831
Mailing Address - Country:US
Mailing Address - Phone:703-753-7744
Mailing Address - Fax:
Practice Address - Street 1:7521 VIRGINIA OAKS DR STE 240
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-3831
Practice Address - Country:US
Practice Address - Phone:703-753-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-06
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305212338225100000X
2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer