Provider Demographics
NPI:1558080234
Name:KAYLA WILKES RN, CLC
Entity Type:Organization
Organization Name:KAYLA WILKES RN, CLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LACTATION COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILKES
Authorized Official - Suffix:
Authorized Official - Credentials:RN, CLC
Authorized Official - Phone:803-609-9761
Mailing Address - Street 1:305 DAPHNE DR
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-7863
Mailing Address - Country:US
Mailing Address - Phone:803-609-9761
Mailing Address - Fax:
Practice Address - Street 1:305 DAPHNE DR
Practice Address - Street 2:
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-7863
Practice Address - Country:US
Practice Address - Phone:803-609-9761
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAYLA WILKES RN, CLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-08-25
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty