Provider Demographics
NPI:1356980395
Name:VALDEZ, KAYLA LYNN (CNP)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:LYNN
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:LYNN
Other - Last Name:VILLAGOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNP
Mailing Address - Street 1:111 W VERNON AVE
Mailing Address - Street 2:
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56537-2741
Mailing Address - Country:US
Mailing Address - Phone:218-736-8000
Mailing Address - Fax:218-739-6725
Practice Address - Street 1:111 W VERNON AVE
Practice Address - Street 2:
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56537-2741
Practice Address - Country:US
Practice Address - Phone:218-736-8000
Practice Address - Fax:218-739-6725
Is Sole Proprietor?:No
Enumeration Date:2019-12-21
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN7036363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily