Provider Demographics
NPI:1255106183
Name:BLAIR, KAYLA (CRNP, FNP-C)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:BLAIR
Suffix:
Gender:F
Credentials:CRNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1854 WAYNE RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17202-8836
Mailing Address - Country:US
Mailing Address - Phone:717-200-7228
Mailing Address - Fax:717-687-1871
Practice Address - Street 1:1854 WAYNE RD STE 2
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17202-8836
Practice Address - Country:US
Practice Address - Phone:717-200-7228
Practice Address - Fax:717-687-1871
Is Sole Proprietor?:No
Enumeration Date:2023-11-21
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP028741363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily