Provider Demographics
NPI:1336875830
Name:BONE, KAYLA (MSN, APRN FNP BC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:BONE
Suffix:
Gender:F
Credentials:MSN, APRN FNP BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3119 HIGHWAY J
Mailing Address - Street 2:
Mailing Address - City:FREDERICKTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:63645-8461
Mailing Address - Country:US
Mailing Address - Phone:573-561-4911
Mailing Address - Fax:
Practice Address - Street 1:3119 HIGHWAY J
Practice Address - Street 2:
Practice Address - City:FREDERICKTOWN
Practice Address - State:MO
Practice Address - Zip Code:63645-8461
Practice Address - Country:US
Practice Address - Phone:573-561-4911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022027524363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily