Healthcare Provider Details

I. General information

NPI: 1427692359
Provider Name (Legal Business Name): MRS. KAYLA HOWARD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAYLA SHANKLAND

II. Dates (important events)

Enumeration Date: 11/04/2019
Last Update Date: 08/19/2022
Certification Date: 08/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

342 MUSKINGUM DR
MARIETTA OH
45750-1435
US

IV. Provider business mailing address

42 COLEGATE DR
MARIETTA OH
45750-2305
US

V. Phone/Fax

Practice location:
  • Phone: 800-321-8293
  • Fax:
Mailing address:
  • Phone: 740-434-1231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: