Provider Demographics
NPI:1508317405
Name:SWITZER, CAYLA (NP-C)
Entity Type:Individual
Prefix:
First Name:CAYLA
Middle Name:
Last Name:SWITZER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:907 GRANT AVE
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39567-7221
Mailing Address - Country:US
Mailing Address - Phone:228-623-5784
Mailing Address - Fax:
Practice Address - Street 1:11516 LAMEY BRIDGE RD
Practice Address - Street 2:STE 2
Practice Address - City:DIBERVILLE
Practice Address - State:MS
Practice Address - Zip Code:39540-2725
Practice Address - Country:US
Practice Address - Phone:228-207-4190
Practice Address - Fax:228-207-4156
Is Sole Proprietor?:No
Enumeration Date:2016-10-17
Last Update Date:2019-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS901819363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS01488072Medicaid