MEDICARE: MRS. KAYLA WILLIAMS

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1982562799
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KAYLA WILLIAMS

Provider Business Mailing Address
First Line	:	1209 MOUNTAIN ROAD PL NE STE R
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7845
Country	:	US
Telephone Number	:	866-450-4673
Fax Number	:

Provider Business Practice Location Address
First Line	:	1209 MOUNTAIN ROAD PL NE STE R
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87110-7845
Country	:	US
Telephone Number	:	866-450-4673
Fax Number	:

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

Provider Enumeration Date	:	01/12/2026
Last Update Date	:	01/12/2026

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