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General NPI Number Information
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NPI Number | 1609234368
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Entity Type | Individual
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Provider Name | KAYLA JEAN BUMBAUGH PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/09/2016
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Last Update Date | 09/10/2021
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Provider Practice Location Address
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Address Line | 120 N 7TH ST STE 101
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-1795
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Country | US
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Telephone | 717-263-1220
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Fax | 717-263-6255
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Provider Business Mailing Address
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Address Line | 785 5TH AVE SUITE 3
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City | CHAMBERSBURG
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State | PA
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Zip | 17201-4232
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Country | US
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Telephone | 717-709-4718
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Fax | 717-217-4218
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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 | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | MA058068
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | MA058068
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License Number State | PA
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