Provider Demographics
NPI:1194501643
Name:KVELL, KAYLA MARIE (DNP APRN, PMHNP-BC)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MARIE
Last Name:KVELL
Suffix:
Gender:F
Credentials:DNP APRN, PMHNP-BC
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:
Other - Last Name:HOLZINGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11280 86TH AVE N
Mailing Address - Street 2:
Mailing Address - City:MAPLE GROVE
Mailing Address - State:MN
Mailing Address - Zip Code:55369-4510
Mailing Address - Country:US
Mailing Address - Phone:612-812-9851
Mailing Address - Fax:
Practice Address - Street 1:400 S 4TH ST STE 410
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1419
Practice Address - Country:US
Practice Address - Phone:612-812-9851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-31
Last Update Date:2024-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN107302084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry