Provider Demographics
NPI:1609439397
Name:MARCUM, KAYLA ELIZABETH LEWIS (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:ELIZABETH LEWIS
Last Name:MARCUM
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:BEREA
Mailing Address - State:KY
Mailing Address - Zip Code:40403-0429
Mailing Address - Country:US
Mailing Address - Phone:859-523-5310
Mailing Address - Fax:859-523-5312
Practice Address - Street 1:3101 RICHMOND RD STE 202
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-1525
Practice Address - Country:US
Practice Address - Phone:859-269-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY3013311363L00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner