Individual
KAYLA M ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 E CHESTNUT ST, SERVICE BUILDING, SUITE 303, LOUISVILLE, KY 40202-1831
(502) 629-5552
(502) 629-3132
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
APPLIED
KY
363AM0700X
Medical Physician Assistant
Primary
PA2167
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100436050
—
KY
01
—
K229490
MEDICARE
KY
Enumeration date
08/23/2016
Last updated
01/21/2021
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