Individual
KAYLA RENE VANDERWALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7430 N SHADELAND AVE STE 200, INDIANAPOLIS, IN 46250-2036
(317) 621-0668
Mailing address
6626 E 75TH ST STE 500, INDIANAPOLIS, IN 46250-2890
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
085007328
IL
363AS0400X
Surgical Physician Assistant
Primary
—
IN
Other
Enumeration date
03/30/2014
Last updated
09/01/2022
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