Healthcare Provider Details

I. General information

NPI: 1043028970
Provider Name (Legal Business Name): KAYLA POLLAK RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/23/2024
Last Update Date: 12/23/2024
Certification Date: 12/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3 PAGE LN # 3A
HAMPTON NH
03842-3279
US

IV. Provider business mailing address

3 PAGE LN # 3A
HAMPTON NH
03842-3279
US

V. Phone/Fax

Practice location:
  • Phone: 603-952-7698
  • Fax:
Mailing address:
  • Phone: 603-952-7698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WX0106X
TaxonomyOccupational Health Registered Nurse
License Number082732-21
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: