Healthcare Provider Details

I. General information

NPI: 1528476736
Provider Name (Legal Business Name): ASHLEIGH KAYLOR FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2014
Last Update Date: 10/12/2022
Certification Date: 10/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2130 W SYCAMORE ST STE 260
KOKOMO IN
46901-6460
US

IV. Provider business mailing address

2130 W SYCAMORE ST STE 260
KOKOMO IN
46901-6460
US

V. Phone/Fax

Practice location:
  • Phone: 765-236-8457
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71005048A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number71005048A
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005048A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: