Provider Demographics
NPI:1497868152
Name:CAMPBELL, KAYLA LEA (CRNA)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:LEA
Last Name:CAMPBELL
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:LEA
Other - Last Name:HARDER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:512 RIVER OAK DR
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-4755
Mailing Address - Country:US
Mailing Address - Phone:515-451-3747
Mailing Address - Fax:
Practice Address - Street 1:512 RIVER OAK DR
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-4755
Practice Address - Country:US
Practice Address - Phone:515-451-3747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAD095688367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered