Provider Demographics
NPI:1770879108
Name:CORLEY, KAYLIN SPENCE (WHNP)
Entity type:Individual
Prefix:MRS
First Name:KAYLIN
Middle Name:SPENCE
Last Name:CORLEY
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:501 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-8124
Mailing Address - Country:US
Mailing Address - Phone:318-442-5800
Mailing Address - Fax:318-442-1109
Practice Address - Street 1:501 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 4A
Practice Address - City:ALEXANDRIA
Practice Address - State:LA
Practice Address - Zip Code:71301-8124
Practice Address - Country:US
Practice Address - Phone:318-442-5800
Practice Address - Fax:318-442-1109
Is Sole Proprietor?:No
Enumeration Date:2011-06-23
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LAAP06509363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health