Provider Demographics
NPI:1700599594
Name:COFIELD, KAYLEE MAY (PA-C)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:MAY
Last Name:COFIELD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAYLEE
Other - Middle Name:MAY
Other - Last Name:CASTLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17500 MAHAN DR
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32309-9565
Mailing Address - Country:US
Mailing Address - Phone:850-491-2036
Mailing Address - Fax:
Practice Address - Street 1:1401 CENTERVILLE RD STE 202
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32308-4638
Practice Address - Country:US
Practice Address - Phone:850-877-7241
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-27
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPA9116860363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant