Provider Demographics
NPI:1578394425
Name:FURLEIGH, KAYLA (RD)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:FURLEIGH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S MAIN ST STE 24
Mailing Address - Street 2:
Mailing Address - City:STILLWATER
Mailing Address - State:OK
Mailing Address - Zip Code:74074-4635
Mailing Address - Country:US
Mailing Address - Phone:307-690-8911
Mailing Address - Fax:
Practice Address - Street 1:901 S MAIN ST STE 24
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:OK
Practice Address - Zip Code:74074-4635
Practice Address - Country:US
Practice Address - Phone:307-690-8911
Practice Address - Fax:888-979-8718
Is Sole Proprietor?:No
Enumeration Date:2024-08-12
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2957133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered