Provider Demographics
NPI:1619758000
Name:NEACE, KAYLA (APRN)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:NEACE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:GOODING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:192 MCCONNELLS TRCE
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40511-8833
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE ST ROACH CANCER CTR 1ST FL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0007
Practice Address - Country:US
Practice Address - Phone:859-257-6006
Practice Address - Fax:859-257-6002
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4017669363LA2100X
KY1144860390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program