Provider Demographics
NPI:1982159364
Name:ZERKLE, KAYLA MARIE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:ZERKLE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:MARIE
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2540 WHEATON RD
Mailing Address - Street 2:
Mailing Address - City:BIDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:45614-9348
Mailing Address - Country:US
Mailing Address - Phone:740-645-1521
Mailing Address - Fax:
Practice Address - Street 1:254 PINECREST DR
Practice Address - Street 2:
Practice Address - City:GALLIPOLIS
Practice Address - State:OH
Practice Address - Zip Code:45631-1347
Practice Address - Country:US
Practice Address - Phone:740-578-4824
Practice Address - Fax:740-578-4821
Is Sole Proprietor?:No
Enumeration Date:2016-08-16
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH019714363LF0000X
OH5993163WA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WA0400XNursing Service ProvidersRegistered NurseAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH218970Medicaid