Provider Demographics
NPI:1699141259
Name:CARR, AYLA LEWIS (FNP-C)
Entity type:Individual
Prefix:
First Name:AYLA
Middle Name:LEWIS
Last Name:CARR
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:AYLA
Other - Middle Name:ANNE
Other - Last Name:LEWIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:41 HILLCREST DR
Mailing Address - Street 2:
Mailing Address - City:BARKHAMSTED
Mailing Address - State:CT
Mailing Address - Zip Code:06063-1121
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:278 VT ROUTE 149
Practice Address - Street 2:
Practice Address - City:WEST PAWLET
Practice Address - State:VT
Practice Address - Zip Code:05775-9798
Practice Address - Country:US
Practice Address - Phone:802-645-0580
Practice Address - Fax:802-645-0587
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2283356363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily