Provider Demographics
NPI:1861895393
Name:HANKS, KAYLA COTHRAN (APRN, NP-C)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:COTHRAN
Last Name:HANKS
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:316 CALHOUN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29401-1113
Mailing Address - Country:US
Mailing Address - Phone:843-847-3225
Mailing Address - Fax:843-847-3247
Practice Address - Street 1:9330 MEDICAL PLAZA DR
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9104
Practice Address - Country:US
Practice Address - Phone:843-847-3225
Practice Address - Fax:843-847-3247
Is Sole Proprietor?:No
Enumeration Date:2014-09-29
Last Update Date:2016-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC19085363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily