Provider Demographics
NPI:1891239000
Name:JOHNSON, KAYLA (APRN)
Entity type:Individual
Prefix:MRS
First Name:KAYLA
Middle Name:
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:KAYLA
Other - Middle Name:M
Other - Last Name:PELFREY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:8600 HIXSON PIKE
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-1515
Mailing Address - Country:US
Mailing Address - Phone:423-842-2197
Mailing Address - Fax:
Practice Address - Street 1:8600 HIXSON PIKE
Practice Address - Street 2:
Practice Address - City:HIXSON
Practice Address - State:TN
Practice Address - Zip Code:37343-1515
Practice Address - Country:US
Practice Address - Phone:423-842-2197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-06
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN21903363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily