Provider Demographics
NPI:1598529109
Name:KNOLMAYER, KAYLA NOELLE
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:NOELLE
Last Name:KNOLMAYER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4900 RIPPLEMEAD CT
Mailing Address - Street 2:
Mailing Address - City:BROOKEVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20882-1838
Mailing Address - Country:US
Mailing Address - Phone:301-602-6719
Mailing Address - Fax:
Practice Address - Street 1:4900 RIPPLEMEAD CT
Practice Address - Street 2:
Practice Address - City:BROOKEVILLE
Practice Address - State:MD
Practice Address - Zip Code:20882-1838
Practice Address - Country:US
Practice Address - Phone:301-602-6719
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant