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Individual
KAYLA MACINNIS
Active
Individual
KAYLA MACINNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, EMT-B
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
22885
CT
2255A2300X
Athletic Trainer
Primary
1084
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2000018481
NATIONAL ATHLETIC TRAINERS ASSOCIATION - BOARD OF CERTIFICATION
CT
01
—
22885
EMT-B
CT
Enumeration date
03/05/2015
Last updated
02/24/2019
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