Provider Demographics
NPI:1982287736
Name:POTTS, KAYLA DANIELLE (FNP)
Entity Type:Individual
Prefix:MS
First Name:KAYLA
Middle Name:DANIELLE
Last Name:POTTS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:DANIELLE
Other - Last Name:POTTS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:KAYLA POTTS, FNP
Mailing Address - Street 1:201 OAK FOREST LN APT 4
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31793-7877
Mailing Address - Country:US
Mailing Address - Phone:229-326-2212
Mailing Address - Fax:
Practice Address - Street 1:201 OAK FOREST LN APT 4
Practice Address - Street 2:
Practice Address - City:TIFTON
Practice Address - State:GA
Practice Address - Zip Code:31793-7877
Practice Address - Country:US
Practice Address - Phone:229-326-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-29
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAF10200167363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care