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General NPI Number Information
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NPI Number | 1316298185
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Entity Type | Individual
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Provider Name | KAYLA ANN THOMPSON FNP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2012
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Last Update Date | 05/22/2020
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Provider Practice Location Address
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Address Line | 10739 DEERWOOD PARK BLVD STE 200
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City | JACKSONVILLE
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State | FL
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Zip | 32256-4839
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Country | US
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Telephone | 615-721-7024
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Fax |
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Provider Business Mailing Address
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Address Line | 802 AMBERWAY DR
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City | PENSACOLA
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State | FL
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Zip | 32506-5669
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 16726
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License Number State | TN
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