Provider Demographics
NPI:1124830005
Name:SPEARS, KAYLEE J (PA-C)
Entity type:Individual
Prefix:MRS
First Name:KAYLEE
Middle Name:J
Last Name:SPEARS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:KAYLEE
Other - Middle Name:J
Other - Last Name:BAYS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:6330 QUADRANGLE DR STE 500
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-8281
Mailing Address - Country:US
Mailing Address - Phone:888-849-7379
Mailing Address - Fax:
Practice Address - Street 1:1901 W HIGHWAY 90
Practice Address - Street 2:
Practice Address - City:MONTICELLO
Practice Address - State:KY
Practice Address - Zip Code:42633-2460
Practice Address - Country:US
Practice Address - Phone:888-849-7379
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYTC111363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant