Provider Demographics
NPI:1619753563
Name:SCRANDIS, KAYLA (CRNP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:SCRANDIS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13626 OTONO DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-5952
Mailing Address - Country:US
Mailing Address - Phone:443-538-8661
Mailing Address - Fax:
Practice Address - Street 1:8840 STANFORD BLVD STE 1600
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-5909
Practice Address - Country:US
Practice Address - Phone:240-512-0141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR231666363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health