Healthcare Provider Details

I. General information

NPI: 1982287736
Provider Name (Legal Business Name): KAYLA DANIELLE HOWARD FNP-C, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA DANIELLE POTTS KAYLA HOWARD, FNP-C

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 VIRGINIA AVE S # 1108
TIFTON GA
31794-8073
US

IV. Provider business mailing address

131 MILL RIDGE CIR
TIFTON GA
31793-5568
US

V. Phone/Fax

Practice location:
  • Phone: 229-326-2212
  • Fax:
Mailing address:
  • Phone: 229-326-2212
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP212066
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN-NP212066
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: