Provider Demographics
NPI:1184469033
Name:KEITH, KAYLA N (PA-C)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:N
Last Name:KEITH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:N
Other - Last Name:JOYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:630 HUNTCO DR APT 1803
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37043-2377
Mailing Address - Country:US
Mailing Address - Phone:407-256-2895
Mailing Address - Fax:
Practice Address - Street 1:1121 N. CHURCH STREET
Practice Address - Street 2:P.O. BOX 10467
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27404-0467
Practice Address - Country:US
Practice Address - Phone:336-207-7005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical