Provider Demographics
NPI:1013710409
Name:HANSON, KAYLA ANN
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANN
Last Name:HANSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:ANN
Other - Last Name:KORKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:175 OLD MURDOCH RD APT 404
Mailing Address - Street 2:
Mailing Address - City:NEWPORT
Mailing Address - State:NC
Mailing Address - Zip Code:28570-6453
Mailing Address - Country:US
Mailing Address - Phone:763-229-2789
Mailing Address - Fax:
Practice Address - Street 1:800 MEADOWS RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33486-2304
Practice Address - Country:US
Practice Address - Phone:561-955-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program