Provider Demographics
NPI:1669789434
Name:ROBINSON, KAYLA B (NP)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:B
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MISS
Other - First Name:KAYLA
Other - Middle Name:B
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:755 BURNSIDE DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-2559
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:755 BURNSIDE DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-2559
Practice Address - Country:US
Practice Address - Phone:803-290-6990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2023-10-23
Deactivation Date:2010-10-07
Deactivation Code:
Reactivation Date:2016-07-27
Provider Licenses
StateLicense IDTaxonomies
SC19911363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health