Healthcare Provider Details

I. General information

NPI: 1487281325
Provider Name (Legal Business Name): KAYLA MARIE STITZ FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA MARIE HENDERSON FNP

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 SUN TEMPLE DR
MADISON AL
35758-8643
US

IV. Provider business mailing address

600 SUN TEMPLE DR
MADISON AL
35758-8643
US

V. Phone/Fax

Practice location:
  • Phone: 256-701-5651
  • Fax: 256-429-9411
Mailing address:
  • Phone: 256-975-4291
  • Fax: 256-325-1890

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number32292
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-172839
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: