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NPI Code Detail

MEDICARE: MRS. KAYLA MARIE DANIELS PA-C

MEDICARE: MRS. KAYLA MARIE DANIELS 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 Assistant0786SD
2363A00000XPhysician Assistant2356NE

General Provider Information

NPI Number : 1487941118
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KAYLA MARIE DANIELS PA-C
Provider Business Mailing Address
First Line : 3800 MEADOWLARK LN
Second Line :
City : NORFOLK
State : NE
Zip : 68701-3154
Country : US
Telephone Number : 605-290-6567
Fax Number :
Provider Business Practice Location Address
First Line : 3775 45TH AVE
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4427
Country : US
Telephone Number : 402-564-7200
Fax Number : 402-564-7210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/01/2011
Last Update Date : 02/01/2022

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Directions to “ MRS. KAYLA MARIE DANIELS PA-C” Practice Location

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