Provider Demographics
NPI:1538906573
Name:WILLIAMS, KAYLA (APRN, DNP, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:APRN, DNP, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7939 ATWATER LN APT 202
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-9189
Mailing Address - Country:US
Mailing Address - Phone:901-592-7474
Mailing Address - Fax:
Practice Address - Street 1:793 TENNESSEE ST
Practice Address - Street 2:
Practice Address - City:BOLIVAR
Practice Address - State:TN
Practice Address - Zip Code:38008-2441
Practice Address - Country:US
Practice Address - Phone:731-228-9068
Practice Address - Fax:901-425-9773
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-09
Last Update Date:2024-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36830363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty