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General NPI Number Information
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NPI Number | 1548053630
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Entity Type | Individual
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Provider Name | KAYLA BROOKE LONGINO FNP-C
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Gender | Female
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Dates
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Enumeration Date | 05/22/2025
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 1201 W 38TH ST
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City | AUSTIN
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State | TX
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Zip | 78705-1006
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Country | US
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Telephone | 512-324-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 806 GIORGIO MORODER DR
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City | HUTTO
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State | TX
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Zip | 78634-2555
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Country | US
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Telephone | 512-413-9559
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1193437
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License Number State | TX
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