Individual
KAYLA HERSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
164 SUMMIT AVE, PROVIDENCE, RI 02906-2853
(401) 793-3550
Mailing address
1535 ATWOOD AVE APT 106, JOHNSTON, RI 02919-3232
(401) 263-9291
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA01473
RI
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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