Provider Demographics
NPI:1679939821
Name:STEVELEY, KAYLA ANN (CNP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANN
Last Name:STEVELEY
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3773 OLENTANGY RIVER RD # ED
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43214-3425
Mailing Address - Country:US
Mailing Address - Phone:614-566-5356
Mailing Address - Fax:614-566-3835
Practice Address - Street 1:3773 OLENTANGY RIVER RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43214-3425
Practice Address - Country:US
Practice Address - Phone:614-566-5356
Practice Address - Fax:614-566-3835
Is Sole Proprietor?:No
Enumeration Date:2016-01-04
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH17665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHH509080Medicare PIN