Provider Demographics
NPI:1528775400
Name:SALVA, KAYLA ROBERTS (FNP-BC)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:ROBERTS
Last Name:SALVA
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19203 TRIPLE CROWN DR
Mailing Address - Street 2:
Mailing Address - City:ABINGDON
Mailing Address - State:VA
Mailing Address - Zip Code:24211-6667
Mailing Address - Country:US
Mailing Address - Phone:276-780-7560
Mailing Address - Fax:
Practice Address - Street 1:1 MEDICAL PARK BLVD STE 300E
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:TN
Practice Address - Zip Code:37620-7497
Practice Address - Country:US
Practice Address - Phone:423-844-6450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024185679363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily