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1679141303 NPI number — KAYLA BARRY PA

NPI Number: 1679141303
Health Care Provider/Practitioner: KAYLA BARRY PA

Information about “1679141303” NPI (KAYLA BARRY PA) exists in 1679141303 in HTML format HTML  |  1679141303 in plain Text format TXT  |  1679141303 in PDF (Portable Document Format) PDF  |  1679141303 in an XML format XML  formats.

NPI Number : 1679141303 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679141303",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "BARRY",
    "FirstName": "KAYLA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "TERREL",
    "OtherFirstName": "KAYLA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "PA",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "3001 QUAIL SPRINGS PKWY FL 5",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "OKLAHOMA CITY",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "73134-2640",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "405-666-9860",
    "MailingAddressFaxNumber": "405-666-9876",
    "FirstLinePracticeLocationAddress": "750 SW 19TH ST STE A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MOORE",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "73160-2974",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "405-666-9860",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "06/17/2021",
    "LastUpdateDate": "12/07/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363A00000X",
        "TaxonomyName": "Physician Assistant",
        "LicenseNumber": "4651",
        "LicenseNumberStateCode": "OK",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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