Provider Demographics
NPI:1508591728
Name:PAYNE, KAYLA HODGE
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:HODGE
Last Name:PAYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 LEMOYNE DR
Mailing Address - Street 2:
Mailing Address - City:DAUPHIN ISLAND
Mailing Address - State:AL
Mailing Address - Zip Code:36528-4400
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:142 LEMOYNE DR
Practice Address - Street 2:
Practice Address - City:DAUPHIN ISLAND
Practice Address - State:AL
Practice Address - Zip Code:36528-4400
Practice Address - Country:US
Practice Address - Phone:205-739-9346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-142417163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant