MEDICARE: KAYLA GILDERSLEEVE KING PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	1371580	ID
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	G187457	IA
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AC008410	MD
4	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	L8-0010949	DE

General Provider Information

NPI Number	:	1598637118
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAYLA GILDERSLEEVE KING PMHNP

Provider Business Mailing Address
First Line	:	1 PERIMETER PARK S STE 100N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-3248
Country	:	US
Telephone Number	:	205-875-8384
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 PERIMETER PARK S STE 100N
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35243-3248
Country	:	US
Telephone Number	:	205-875-8384
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2025
Last Update Date	:	06/23/2026

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