Provider Demographics
NPI:1942065453
Name:ATKISON, KAYLA FOWLER (RN)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:FOWLER
Last Name:ATKISON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:DANIELLE
Other - Last Name:FOWLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3003 FOREST BRK
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-5248
Mailing Address - Country:US
Mailing Address - Phone:205-270-6628
Mailing Address - Fax:
Practice Address - Street 1:2700 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-3360
Practice Address - Country:US
Practice Address - Phone:205-333-4970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-14
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-178451163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn