Healthcare Provider Details

I. General information

NPI: 1902350952
Provider Name (Legal Business Name): KAYLA SELLERS FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2016
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

511 OAKWOOD BLVD STE 200
ROUND ROCK TX
78681-4068
US

IV. Provider business mailing address

1400 N IH 35 STE 300
AUSTIN TX
78701-1926
US

V. Phone/Fax

Practice location:
  • Phone: 855-481-8375
  • Fax:
Mailing address:
  • Phone: 512-376-2999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP131301
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: