MEDICARE: MS. KAYLA RENEE ALLEN WHNP

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
1	363LW0102X	Women's Health Nurse Practitioner	APRN-NP295693	GA

General Provider Information

NPI Number	:	1528830171
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KAYLA RENEE ALLEN WHNP

Provider Business Mailing Address
First Line	:	2116 LUNCEFORD LN SW
Second Line	:
City	:	LILBURN
State	:	GA
Zip	:	30047-4752
Country	:	US
Telephone Number	:	646-300-5253
Fax Number	:

Provider Business Practice Location Address
First Line	:	371 E PACES FERRY RD NE STE 730
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-2372
Country	:	US
Telephone Number	:	470-223-6557
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2023
Last Update Date	:	05/03/2026

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