Provider Demographics
NPI:1982133161
Name:STANAGE, KAYLA N (APRN)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:N
Last Name:STANAGE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1661 AIRPORT RD STE F
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-8184
Mailing Address - Country:US
Mailing Address - Phone:501-651-4300
Mailing Address - Fax:501-547-5688
Practice Address - Street 1:1661 AIRPORT RD STE F
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-8184
Practice Address - Country:US
Practice Address - Phone:501-651-4300
Practice Address - Fax:501-547-5688
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARATP-001143363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily