Individual
MRS. KAYLA DANIELLE YATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
308 8TH ST, BRISTOL, TN 37620-2228
(423) 844-6860
Mailing address
308 8TH ST, BRISTOL, TN 37620-2228
(423) 844-6860
(423) 844-0613
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4189
TN
363A00000X
Physician Assistant
Primary
4189
TN
363AM0700X
Medical Physician Assistant
0110007278
VA
Other
Enumeration date
08/04/2020
Last updated
04/08/2021
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