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NPI Code Detail

MEDICARE: KAYLA ANN JUDD PA-C

MEDICARE: KAYLA ANN JUDD PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant006848CT
2363A00000XPhysician AssistantPA8779MA

General Provider Information

NPI Number : 1366176372
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAYLA ANN JUDD PA-C
Provider Business Mailing Address
First Line : 263 FARMINGTON AVE
Second Line :
City : FARMINGTON
State : CT
Zip : 06030-1104
Country : US
Telephone Number : 860-679-2588
Fax Number : 860-679-4015
Provider Business Practice Location Address
First Line : 263 FARMINGTON AVE
Second Line :
City : FARMINGTON
State : CT
Zip : 06030-8082
Country : US
Telephone Number : 860-679-2588
Fax Number : 860-679-4015
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2022
Last Update Date : 02/17/2026

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Directions to “ KAYLA ANN JUDD PA-C” Practice Location

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