Provider Demographics
NPI:1144722679
Name:KNOWLES, KAYLA KATHRYN (RN)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:KATHRYN
Last Name:KNOWLES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:KAYLA
Other - Middle Name:KATHRYN
Other - Last Name:MAIER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:225 N MINNESOTA ST
Mailing Address - Street 2:
Mailing Address - City:MUSCODA
Mailing Address - State:WI
Mailing Address - Zip Code:53573-9177
Mailing Address - Country:US
Mailing Address - Phone:608-739-3199
Mailing Address - Fax:
Practice Address - Street 1:225 N MINNESOTA ST
Practice Address - Street 2:
Practice Address - City:MUSCODA
Practice Address - State:WI
Practice Address - Zip Code:53573-9177
Practice Address - Country:US
Practice Address - Phone:608-739-3199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-28
Last Update Date:2018-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI240078163WH0200X, 163WP0200X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WH0200XNursing Service ProvidersRegistered NurseHome Health
No163WP0200XNursing Service ProvidersRegistered NursePediatrics