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General NPI Number Information
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NPI Number | 1578293908
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Entity Type | Individual
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Provider Name | KATHRYN LAY APRN
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Gender | Female
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Dates
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Enumeration Date | 06/17/2022
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Last Update Date | 02/22/2024
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Provider Practice Location Address
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Address Line | 141 E CENTRAL AVE
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City | WINTER HAVEN
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State | FL
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Zip | 33880-6338
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Country | US
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Telephone | 863-272-6536
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Fax |
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Provider Business Mailing Address
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Address Line | 925 S ORANGE AVE
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City | BARTOW
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State | FL
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Zip | 33830-5728
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Country | US
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Telephone | 863-450-9321
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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 | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 11020211
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License Number State | FL
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