Provider Demographics
NPI:1063216901
Name:NOWAK, KAYLA LYNN
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:LYNN
Last Name:NOWAK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3328 OUTTA PL
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99517-2032
Mailing Address - Country:US
Mailing Address - Phone:907-540-2030
Mailing Address - Fax:
Practice Address - Street 1:4600 ABBOTT RD
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99507-4314
Practice Address - Country:US
Practice Address - Phone:907-346-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health