Provider Demographics
NPI:1790340289
Name:ERFURTH, KAYLA ELAINE
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:ELAINE
Last Name:ERFURTH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 COOPER LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT EDEN
Mailing Address - State:KY
Mailing Address - Zip Code:40046-8126
Mailing Address - Country:US
Mailing Address - Phone:502-902-0951
Mailing Address - Fax:
Practice Address - Street 1:1123 N BARDSTOWN RD UNIT 2
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-7844
Practice Address - Country:US
Practice Address - Phone:502-538-6333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-09
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY224Z00000X
224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant