Healthcare Provider Details

I. General information

NPI: 1104602259
Provider Name (Legal Business Name): KAYLA NEEPER DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2023
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 TOWN CENTER BLVD STE 205
FLEMING ISLAND FL
32003-3359
US

IV. Provider business mailing address

1562 WINSTON LN
FLEMING ISLAND FL
32003-7402
US

V. Phone/Fax

Practice location:
  • Phone: 904-718-3416
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NP0017X
TaxonomyPediatric Chiropractor
License Number2023036166
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: