Provider Demographics
NPI:1124490073
Name:BAKANE, KAYLA (PA-C)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:BAKANE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:4351 BOOTH CALLOWAY RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7378
Mailing Address - Country:US
Mailing Address - Phone:817-284-1165
Mailing Address - Fax:817-284-2677
Practice Address - Street 1:4351 BOOTH CALLOWAY RD
Practice Address - Street 2:SUITE 101
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7378
Practice Address - Country:US
Practice Address - Phone:817-284-1165
Practice Address - Fax:817-284-2677
Is Sole Proprietor?:No
Enumeration Date:2015-10-29
Last Update Date:2015-10-29
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical