Provider Demographics
NPI:1740024116
Name:CARROLA, KYRAH CASHAY
Entity type:Individual
Prefix:
First Name:KYRAH
Middle Name:CASHAY
Last Name:CARROLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3780 N.KING ST
Mailing Address - Street 2:
Mailing Address - City:COOLIDGE
Mailing Address - State:AZ
Mailing Address - Zip Code:85128
Mailing Address - Country:US
Mailing Address - Phone:520-840-0008
Mailing Address - Fax:
Practice Address - Street 1:372 1/2 W NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:COOLIDGE
Practice Address - State:AZ
Practice Address - Zip Code:85128
Practice Address - Country:US
Practice Address - Phone:520-840-0008
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program