Provider Demographics
NPI:1255077160
Name:ADAMS, KAYLA ANN (APRN)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANN
Last Name:ADAMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
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Mailing Address - Street 1:4620 ROGERS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72903-3121
Mailing Address - Country:US
Mailing Address - Phone:479-384-5380
Mailing Address - Fax:479-384-5382
Practice Address - Street 1:4620 ROGERS AVE STE 101
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-3121
Practice Address - Country:US
Practice Address - Phone:479-384-5380
Practice Address - Fax:479-384-5382
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-12
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AR219611207Q00000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine