Provider Demographics
NPI:1700316049
Name:CONTRERAS, KAYLA MICHELLE (RN)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MICHELLE
Last Name:CONTRERAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5635 VAN CLEEF ST APT 2
Mailing Address - Street 2:
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-4025
Mailing Address - Country:US
Mailing Address - Phone:718-801-7855
Mailing Address - Fax:
Practice Address - Street 1:201 E 42ND ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017-5731
Practice Address - Country:US
Practice Address - Phone:212-871-0619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-19
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF432439-01363LA2100X
NY730829163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care