Healthcare Provider Details

I. General information

NPI: 1881510063
Provider Name (Legal Business Name): KAYLA PAGE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12135 PANAMA CITY BEACH PKWY BAY WELLNESS
PANAMA CITY BEACH FL
32407-2609
US

IV. Provider business mailing address

4920 SHURER LN
PANAMA CITY FL
32404-8970
US

V. Phone/Fax

Practice location:
  • Phone: 850-270-8341
  • Fax:
Mailing address:
  • Phone: 903-426-4016
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: