Provider Demographics
NPI:1730776402
Name:HERRERA, KAYLEE JENNA (APRN FNP-BC)
Entity type:Individual
Prefix:
First Name:KAYLEE
Middle Name:JENNA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:APRN FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14784 SW 71ST TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33193-1029
Mailing Address - Country:US
Mailing Address - Phone:786-853-3405
Mailing Address - Fax:
Practice Address - Street 1:9300 SW 72ND ST
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33173-3205
Practice Address - Country:US
Practice Address - Phone:786-853-3405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-28
Last Update Date:2020-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11009435363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily