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Individual

KAYLA CLEMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
6144 AIRPORT BLVD, MOBILE, AL 36608-3143
(251) 476-5050
(251) 450-2770
Mailing address
PO BOX 86144, MOBILE, AL 36689-6144
(251) 476-5050
(251) 450-2770

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1-136281
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
176035
AL
01
511-60221
BCBS OF AL
01
P01499103
RR MEDICARE
01
Z98006
VIVA
Enumeration date
01/26/2015
Last updated
08/09/2016
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