Provider Demographics
NPI:1710585781
Name:LESHER, KAYLA (APRN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:
Last Name:LESHER
Suffix:
Gender:F
Credentials:APRN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:209 OLD HARRODS CREEK RD # 400
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-2553
Mailing Address - Country:US
Mailing Address - Phone:502-337-8149
Mailing Address - Fax:502-385-6659
Practice Address - Street 1:209 OLD HARRODS CREEK RD # 400
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40223-2553
Practice Address - Country:US
Practice Address - Phone:502-337-8149
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-13
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3015324363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100702920Medicaid