Provider Demographics
NPI:1164267779
Name:BRATTIN, KAYLA MARIE (RN, BSN, CRNA)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:BRATTIN
Suffix:
Gender:F
Credentials:RN, BSN, CRNA
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:MASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6731 RACCOON RD
Mailing Address - Street 2:
Mailing Address - City:GRANBY
Mailing Address - State:MO
Mailing Address - Zip Code:64844-7111
Mailing Address - Country:US
Mailing Address - Phone:417-592-4069
Mailing Address - Fax:
Practice Address - Street 1:444 FOUR STATES DR STE 2
Practice Address - Street 2:
Practice Address - City:GALENA
Practice Address - State:KS
Practice Address - Zip Code:66739-4325
Practice Address - Country:US
Practice Address - Phone:620-783-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO2025019906367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program