KAYLA R LICARI P.A.-C NPI 1770811903

NPI Information

NPI: 1770811903
Provider Name: KAYLA R LICARI, P.A.-C
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

Address:
3700 52ND ST SE
GRAND RAPIDS, MI
ZIP 49512
Phone: (616) 656-3700
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Kayla R Licari, P.A.-C is a medical physician assistant in Grand Rapids, MI. Kayla R Licari, P.A.-C NPI is 1770811903. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

3700 52ND ST SE
GRAND RAPIDS, MI
ZIP 49512-637
Phone: (616) 656-3700
Fax: (616) 656-3701

The enumeration date for this NPI number is 11/30/2009 and was last updated on 11/30/2009.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	5601005659	MICHIGAN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	5601005659	OTHER	MICHIGAN	STATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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