Provider Demographics
NPI:1629850946
Name:SCRUGGS, KAYLEY RYAN (CNM, WHNP-BC)
Entity Type:Individual
Prefix:
First Name:KAYLEY
Middle Name:RYAN
Last Name:SCRUGGS
Suffix:
Gender:F
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2814 JOYCE AVE
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30032-4362
Mailing Address - Country:US
Mailing Address - Phone:601-287-2259
Mailing Address - Fax:
Practice Address - Street 1:5780 PEACHTREE DUNWOODY RD STE 195
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1513
Practice Address - Country:US
Practice Address - Phone:770-751-3600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-20
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN269535367A00000X, 363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health