Provider Demographics
NPI:1881435089
Name:JARAMILLO, KAYLA
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:JARAMILLO
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 1:1957 COMMERCE CENTER CIR STE B
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86301-7408
Mailing Address - Country:US
Mailing Address - Phone:928-607-8427
Mailing Address - Fax:
Practice Address - Street 1:1957 COMMERCE CENTER CIR STE B
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86301-7408
Practice Address - Country:US
Practice Address - Phone:928-607-8427
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty