Healthcare Provider Details

I. General information

NPI: 1134598832
Provider Name (Legal Business Name): KAYLA HALL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2015
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 54
HARRIMAN NY
10926-0054
US

IV. Provider business mailing address

PO BOX 54
HARRIMAN NY
10926-0054
US

V. Phone/Fax

Practice location:
  • Phone: 929-240-1971
  • Fax:
Mailing address:
  • Phone: 929-240-1971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF360077-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: