Individual
KAYLA L GORE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4250 HOSPITAL DR, MARIANNA, FL 32446-1917
(850) 482-7200
Mailing address
705 KRISTANNA DR, PANAMA CITY, FL 32405-3274
(850) 319-4139
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN9278587
FL
367500000X
Certified Registered Nurse Anesthetist
Primary
ARNP9278587
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G01PT
BCBSFL
FL
Enumeration date
05/29/2014
Last updated
10/22/2014
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