Healthcare Provider Details

I. General information

NPI: 1114822046
Provider Name (Legal Business Name): KAYLA MARIE CARDONA DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2026
Last Update Date: 10/12/2026
Certification Date: 10/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 WILBRAHAM RD
SPRINGFIELD MA
01109-3161
US

IV. Provider business mailing address

11 WILBRAHAM RD
SPRINGFIELD MA
01109-3161
US

V. Phone/Fax

Practice location:
  • Phone: 413-794-2511
  • Fax: 413-794-8428
Mailing address:
  • Phone: 413-794-2511
  • Fax: 413-794-8428

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberRN2357684
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: