Healthcare Provider Details

I. General information

NPI: 1124758354
Provider Name (Legal Business Name): KAYLA HUKILL CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2022
Last Update Date: 03/22/2023
Certification Date: 03/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29000 CENTER RIDGE RD
WESTLAKE OH
44145-5219
US

IV. Provider business mailing address

29000 CENTER RIDGE RD
WESTLAKE OH
44145-5219
US

V. Phone/Fax

Practice location:
  • Phone: 440-856-9543
  • Fax:
Mailing address:
  • Phone: 440-827-2991
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0031508
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberLE-00041845
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: