Provider Demographics
NPI:1497320337
Name:GODSEY, KAYLA (DNP)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:
Last Name:GODSEY
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:351 BRUCE RD
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72466-8344
Mailing Address - Country:US
Mailing Address - Phone:870-307-4348
Mailing Address - Fax:
Practice Address - Street 1:2524 ALEXANDER DR STE A
Practice Address - Street 2:
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401-7193
Practice Address - Country:US
Practice Address - Phone:870-307-4348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-24
Last Update Date:2021-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR215024363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care