Healthcare Provider Details

I. General information

NPI: 1689938508
Provider Name (Legal Business Name): KAYLA GEORGE PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KAYLA MARIE ARMSTRONG

II. Dates (important events)

Enumeration Date: 06/26/2012
Last Update Date: 01/09/2024
Certification Date: 01/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 2ND ST NE
CEDAR RAPIDS IA
52401-1001
US

IV. Provider business mailing address

418 2ND ST NE
CEDAR RAPIDS IA
52401-1001
US

V. Phone/Fax

Practice location:
  • Phone: 319-398-1697
  • Fax:
Mailing address:
  • Phone: 319-398-1697
  • Fax: 989-399-8233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number106316
License Number StateIA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: