Provider Demographics
NPI:1710665385
Name:BOYD, KAYLA (PMHNP-BC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:BOYD
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:BOYD-BAUCUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11 MCLEOD LN
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-3650
Mailing Address - Country:US
Mailing Address - Phone:270-245-2413
Mailing Address - Fax:877-302-0536
Practice Address - Street 1:11 MCLEOD LN
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-3650
Practice Address - Country:US
Practice Address - Phone:270-245-2413
Practice Address - Fax:877-302-0536
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4006747363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty