Provider Demographics
NPI:1518400100
Name:BARNARD, KAYLA J (PA-C)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:J
Last Name:BARNARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:JULIA
Other - Last Name:TABATT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:9201 W BROADWAY AVE
Mailing Address - Street 2:SUITE 601
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55445-1923
Mailing Address - Country:US
Mailing Address - Phone:763-587-7900
Mailing Address - Fax:763-257-8356
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2926
Practice Address - Country:US
Practice Address - Phone:763-581-6555
Practice Address - Fax:763-581-4771
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12293363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant