Individual
KAYLA WATERHOUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
30 E APPLE ST STE 5254A, DAYTON, OH 45409-2939
(937) 208-4200
Mailing address
4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 45433-5529
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.006887RX
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0457053
—
OH
Enumeration date
08/19/2021
Last updated
07/22/2025
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