Individual
KAYLA DIANE HARDESTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A-C, PT
Contact information
Practice address
511 WINDSOR DR, STILLWATER, OK 74074-6962
(405) 707-0900
Mailing address
PO BOX 720006, NORMAN, OK 73070-4006
(405) 707-0900
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1686
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200215910A
—
OK
Enumeration date
11/01/2007
Last updated
03/10/2020
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