Provider Demographics
NPI:1588181861
Name:WEST, KAYLA ASHLEY (PMHNP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:ASHLEY
Last Name:WEST
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:ASHLEY
Other - Last Name:WILLIAMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:223 MADISON ST
Mailing Address - Street 2:STE 103
Mailing Address - City:MADISON
Mailing Address - State:TN
Mailing Address - Zip Code:37115-3660
Mailing Address - Country:US
Mailing Address - Phone:423-282-1480
Mailing Address - Fax:
Practice Address - Street 1:223 MADISON ST STE 103
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:TN
Practice Address - Zip Code:37115-3660
Practice Address - Country:US
Practice Address - Phone:615-860-0808
Practice Address - Fax:615-860-0809
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-27
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN000200650163WP0808X
TN23237363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health