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General NPI Number Information
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NPI Number | 1548646847
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Entity Type | Individual
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Provider Name | KAYLA NIXON FNP
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Gender | Female
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 05/14/2024
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Provider Practice Location Address
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Address Line | 710 SUNSET DR STE E
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City | LA GRANDE
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State | OR
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Zip | 97850-1200
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Country | US
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Telephone | 541-663-3100
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Fax | 541-975-5135
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Provider Business Mailing Address
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Address Line | PO BOX 3290
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City | LA GRANDE
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State | OR
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Zip | 97850-7290
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Country | US
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Telephone | 541-963-1967
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Fax | 541-975-5135
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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 | 201508098NP-PP
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License Number State | OR
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