Provider Demographics
NPI:1689286262
Name:METZ, KAYLA DAWN (NP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:DAWN
Last Name:METZ
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:WETUMPKA
Mailing Address - State:AL
Mailing Address - Zip Code:36092-0003
Mailing Address - Country:US
Mailing Address - Phone:334-567-4311
Mailing Address - Fax:334-514-3686
Practice Address - Street 1:101 HUNTERS MOUNTAIN PKWY
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:AL
Practice Address - Zip Code:36079-5895
Practice Address - Country:US
Practice Address - Phone:334-465-7056
Practice Address - Fax:833-696-0057
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-134380363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALF05200535OtherFNP
AL1-134380OtherMEDICAL LICENSE