Provider Demographics
NPI:1962573162
Name:GROSS, KAYLA D (ARNP)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:D
Last Name:GROSS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:D
Other - Last Name:ESSMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:3707 SW 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2084
Mailing Address - Country:US
Mailing Address - Phone:785-270-4630
Mailing Address - Fax:785-270-4628
Practice Address - Street 1:3707 SW 6TH AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2084
Practice Address - Country:US
Practice Address - Phone:785-270-4630
Practice Address - Fax:785-270-4628
Is Sole Proprietor?:No
Enumeration Date:2006-11-11
Last Update Date:2011-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS74315363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
P07624Medicare UPIN
160949Medicare ID - Type Unspecified