Provider Demographics
NPI:1457132870
Name:SMITH, KAYLA LYN (PA-C)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:LYN
Last Name:SMITH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3393 TIMBER LN
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:PA
Mailing Address - Zip Code:16148-6037
Mailing Address - Country:US
Mailing Address - Phone:727-278-5834
Mailing Address - Fax:
Practice Address - Street 1:3393 TIMBER LN
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:PA
Practice Address - Zip Code:16148-6037
Practice Address - Country:US
Practice Address - Phone:727-278-5834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty