Individual
KAYLEIGH VERNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 373-7584
Mailing address
647 E WATERFRONT DR APT 8304, MUNHALL, PA 15120-5041
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
31647243
PA
Other
Enumeration date
05/15/2017
Last updated
03/17/2018
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