Provider Demographics
NPI:1851128235
Name:COLBURN, KAYLA DAWN (RN, PHN, IBCLC)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:DAWN
Last Name:COLBURN
Suffix:
Gender:F
Credentials:RN, PHN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21779 BELMONT DR
Mailing Address - Street 2:
Mailing Address - City:PALO CEDRO
Mailing Address - State:CA
Mailing Address - Zip Code:96073-8739
Mailing Address - Country:US
Mailing Address - Phone:530-524-2354
Mailing Address - Fax:530-224-4230
Practice Address - Street 1:2301 SATURN SKWY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96002-2813
Practice Address - Country:US
Practice Address - Phone:530-224-4226
Practice Address - Fax:530-224-4230
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA823521163WL0100X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant