Provider Demographics
NPI:1457695330
Name:PAYTON, KAYLA ANN (CPNP)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:ANN
Last Name:PAYTON
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:ANN
Other - Last Name:WOODS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:HANNIBAL
Mailing Address - State:MO
Mailing Address - Zip Code:63401-1239
Mailing Address - Country:US
Mailing Address - Phone:573-406-5888
Mailing Address - Fax:573-248-5264
Practice Address - Street 1:1600 N MORLEY ST
Practice Address - Street 2:
Practice Address - City:MOBERLY
Practice Address - State:MO
Practice Address - Zip Code:65270-3666
Practice Address - Country:US
Practice Address - Phone:660-372-9595
Practice Address - Fax:660-395-9596
Is Sole Proprietor?:No
Enumeration Date:2012-11-16
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012036197363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics