Provider Demographics
NPI:1841873932
Name:SMILEY, KAYLA BAILEY (NP)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:BAILEY
Last Name:SMILEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:AMY
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2225 HAWTHORNE TRCE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:GA
Mailing Address - Zip Code:30655-4038
Mailing Address - Country:US
Mailing Address - Phone:678-620-4323
Mailing Address - Fax:
Practice Address - Street 1:887 W MARIETTA ST NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318-5252
Practice Address - Country:US
Practice Address - Phone:888-772-0076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-05
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN280286363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily