Healthcare Provider Details

I. General information

NPI: 1639548936
Provider Name (Legal Business Name): KAYLA E NEWBY N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA E POWELL N.P.

II. Dates (important events)

Enumeration Date: 09/17/2015
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 ENTERPRISE DR STE A
PENDLETON IN
46064-9038
US

IV. Provider business mailing address

6626 E 75TH ST SUITE 500
INDIANAPOLIS IN
46250-2805
US

V. Phone/Fax

Practice location:
  • Phone: 765-298-4567
  • Fax: 765-298-2984
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71005877A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License Number28191767A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: