Healthcare Provider Details

I. General information

NPI: 1821920448
Provider Name (Legal Business Name): KAILA HARPIN ATC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

1073 N BENSON RD
FAIRFIELD CT
06824-5195
US

IV. Provider business mailing address

102 TROJAN DR APT 2
BRIDGEPORT CT
06610-1144
US

V. Phone/Fax

Practice location:
  • Phone: 203-254-4000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number000872
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: