Provider Demographics
NPI:1952050312
Name:WHITLEY, KAYLA SUE (DNP, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:SUE
Last Name:WHITLEY
Suffix:
Gender:F
Credentials:DNP, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2076 INGLESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-2028
Mailing Address - Country:US
Mailing Address - Phone:478-254-8305
Mailing Address - Fax:
Practice Address - Street 1:2076 INGLESIDE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-2028
Practice Address - Country:US
Practice Address - Phone:478-254-8305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-22
Last Update Date:2024-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN239403207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology