Healthcare Provider Details

I. General information

NPI: 1417339557
Provider Name (Legal Business Name): KAYLA DUBOIS CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA TWILLEY CRNP

II. Dates (important events)

Enumeration Date: 06/25/2015
Last Update Date: 05/29/2026
Certification Date: 05/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 MEDICAL PARK DR E
BIRMINGHAM AL
35235-3430
US

IV. Provider business mailing address

5395 QUAIL RIDGE RD
GARDENDALE AL
35071-2983
US

V. Phone/Fax

Practice location:
  • Phone: 205-838-3025
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-127712
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: