Provider Demographics
NPI:1649781691
Name:LINVILLE, KAYLA MARIE (APRN)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:MARIE
Last Name:LINVILLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:MARIE
Other - Last Name:CUMMINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 550
Mailing Address - Street 2:
Mailing Address - City:VANCEBURG
Mailing Address - State:KY
Mailing Address - Zip Code:41179-0550
Mailing Address - Country:US
Mailing Address - Phone:606-796-3029
Mailing Address - Fax:
Practice Address - Street 1:910 KENTON STATION DR
Practice Address - Street 2:
Practice Address - City:MAYSVILLE
Practice Address - State:KY
Practice Address - Zip Code:41056-9613
Practice Address - Country:US
Practice Address - Phone:606-759-0490
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1137267163W00000X
KY3012111363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY3012111OtherAPRN LICENSE
KY1137267OtherREGISTERED NURSE LICENSURE