Provider Demographics
NPI:1841748837
Name:DELVALLE, KAYLA LIANY (NP-C)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:LIANY
Last Name:DELVALLE
Suffix:
Gender:F
Credentials:NP-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:221 LONGWOOD AVE
Mailing Address - Street 2:ROOM 381
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5804
Mailing Address - Country:US
Mailing Address - Phone:617-732-5693
Mailing Address - Fax:617-525-0436
Practice Address - Street 1:221 LONGWOOD AVE
Practice Address - Street 2:ROOM 381
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5804
Practice Address - Country:US
Practice Address - Phone:617-732-5693
Practice Address - Fax:617-525-0436
Is Sole Proprietor?:No
Enumeration Date:2016-09-19
Last Update Date:2020-09-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN2286634363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily