Provider Demographics
NPI:1386528669
Name:FRIDLEY, KAYLA MICHELLE (APRN)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:MICHELLE
Last Name:FRIDLEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:338 NE SEEDLING LOOP
Mailing Address - Street 2:
Mailing Address - City:LAKE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32055-6726
Mailing Address - Country:US
Mailing Address - Phone:863-447-5811
Mailing Address - Fax:863-447-5811
Practice Address - Street 1:2218 W US HIGHWAY 90 STE 102
Practice Address - Street 2:
Practice Address - City:LAKE CITY
Practice Address - State:FL
Practice Address - Zip Code:32055-7281
Practice Address - Country:US
Practice Address - Phone:386-243-8991
Practice Address - Fax:386-243-8997
Is Sole Proprietor?:No
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11041279363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily