MEDICARE: MRS. KAYLA DANIELLE HOWARD FNP-C, PMHNP-BC

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APRN-NP212066	GA
2	363LF0000X	Family Nurse Practitioner	APRN-NP212066	GA

General Provider Information

NPI Number	:	1982287736
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAYLA DANIELLE HOWARD FNP-C, PMHNP-BC

Provider Business Mailing Address
First Line	:	2402 TIFT AVE N
Second Line	:
City	:	TIFTON
State	:	GA
Zip	:	31794-1883
Country	:	US
Telephone Number	:	229-382-7898
Fax Number	:	229-386-5818

Provider Business Practice Location Address
First Line	:	2402 TIFT AVE N
Second Line	:
City	:	TIFTON
State	:	GA
Zip	:	31794-1883
Country	:	US
Telephone Number	:	229-382-7898
Fax Number	:	229-386-5818

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

Provider Enumeration Date	:	04/29/2021
Last Update Date	:	05/11/2026

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