Healthcare Provider Details

I. General information

NPI: 1871239194
Provider Name (Legal Business Name): KAYLA M GARCIA-SOLTERO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

429 N 21ST ST
CAMP HILL PA
17011-2202
US

IV. Provider business mailing address

429 N 21ST ST
CAMP HILL PA
17011-2202
US

V. Phone/Fax

Practice location:
  • Phone: 717-761-7244
  • Fax: 717-761-2055
Mailing address:
  • Phone: 717-761-7244
  • Fax: 717-761-2055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberMA063509
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: