Healthcare Provider Details

I. General information

NPI: 1962329581
Provider Name (Legal Business Name): KAYLA MCCRANIE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA JOHNSON

II. Dates (important events)

Enumeration Date: 07/03/2026
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 SANSBURY TRL
WARNER ROBINS GA
31088-3142
US

IV. Provider business mailing address

206 SANSBURY TRL
WARNER ROBINS GA
31088-3142
US

V. Phone/Fax

Practice location:
  • Phone: 229-942-5174
  • Fax:
Mailing address:
  • Phone: 229-942-5174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number202605692
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: