Provider Demographics
NPI:1730651472
Name:NUNEMACHER, KAYLA MARIE (PA-C)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:NUNEMACHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 E BERTSCH ST
Mailing Address - Street 2:
Mailing Address - City:LANSFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18232-2002
Mailing Address - Country:US
Mailing Address - Phone:570-249-4037
Mailing Address - Fax:
Practice Address - Street 1:523 E 72ND ST FL 7
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4099
Practice Address - Country:US
Practice Address - Phone:212-606-1227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022711-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant