Provider Demographics
NPI:1811578370
Name:PARKER, KAYLA LYNN (CNP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:LYNN
Last Name:PARKER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23505 SMITHTOWN RD STE 110
Mailing Address - Street 2:
Mailing Address - City:EXCELSIOR
Mailing Address - State:MN
Mailing Address - Zip Code:55331-4542
Mailing Address - Country:US
Mailing Address - Phone:763-458-9494
Mailing Address - Fax:763-647-2477
Practice Address - Street 1:23505 SMITHTOWN RD STE 110
Practice Address - Street 2:
Practice Address - City:EXCELSIOR
Practice Address - State:MN
Practice Address - Zip Code:55331-4542
Practice Address - Country:US
Practice Address - Phone:763-458-9494
Practice Address - Fax:763-647-2477
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-16
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN8141363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily