Provider Demographics
NPI:1760085914
Name:QUAN, KAYLA ANN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAYLA
Middle Name:ANN
Last Name:QUAN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4255 QUAKER LANE
Mailing Address - Street 2:
Mailing Address - City:NORTH KINGSTOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02852
Mailing Address - Country:US
Mailing Address - Phone:401-372-9101
Mailing Address - Fax:401-519-9853
Practice Address - Street 1:4255 QUAKER LANE
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852
Practice Address - Country:US
Practice Address - Phone:401-372-9101
Practice Address - Fax:401-519-9853
Is Sole Proprietor?:No
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIRPH05326183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist