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NPI Code Detail

MEDICARE: KAYLA ASH

MEDICARE: KAYLA ASH
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
1363LF0000XFamily Nurse Practitioner2151012MN

General Provider Information

NPI Number : 1649758145
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA ASH
Provider Business Mailing Address
First Line : 14468 170TH ST
Second Line :
City : MILACA
State : MN
Zip : 56353-3219
Country : US
Telephone Number : 320-291-9388
Fax Number :
Provider Business Practice Location Address
First Line : 1555 NORTHWAY DR STE 100
Second Line :
City : SAINT CLOUD
State : MN
Zip : 56303-1258
Country : US
Telephone Number : 320-240-3114
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2018
Last Update Date : 08/06/2018

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Directions to “ KAYLA ASH ” Practice Location

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