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General NPI Number Information
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NPI Number | 1508738691
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Entity Type | Individual
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Provider Name | KAYLA NICOLE ROBERTS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 09/19/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 6016 CROSS COUNTRY BLVD
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City | MARIANNA
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State | FL
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Zip | 32446-2511
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Country | US
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Telephone | 850-693-8693
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Fax |
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Provider Business Mailing Address
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Address Line | 6016 CROSS COUNTRY BLVD
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City | MARIANNA
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State | FL
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Zip | 32446-2511
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Country | US
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Telephone | 850-693-8693
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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 | 3-002701
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 11041231
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License Number State | FL
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