Healthcare Provider Details

I. General information

NPI: 1801669668
Provider Name (Legal Business Name): KAYLA MEININGER RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2023
Last Update Date: 11/03/2023
Certification Date: 11/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 NOYES ST
UTICA NY
13502-3854
US

IV. Provider business mailing address

13 CRESTHILL DR
WHITESBORO NY
13492-2220
US

V. Phone/Fax

Practice location:
  • Phone: 315-738-3600
  • Fax:
Mailing address:
  • Phone: 315-723-8455
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number638548
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: