Basic Information
| Provider Information | |||||||||
| NPI: | 1447707559 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GILLILAND-ALFORD | ||||||||
| FirstName: | KAYLA | ||||||||
| MiddleName: | BROOKE | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CRNP | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | GILILLILAND | ||||||||
| OtherFirstName: | KAYLA | ||||||||
| OtherMiddleName: | BROOKE | ||||||||
| OtherNamePrefix: | |||||||||
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| OtherCredential: | |||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 95 WALL ST | ||||||||
| Address2: | |||||||||
| City: | ALBERTVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359517392 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2568783999 | ||||||||
| FaxNumber: | 2568783779 | ||||||||
| Practice Location | |||||||||
| Address1: | 95 WALL ST STE B | ||||||||
| Address2: | |||||||||
| City: | ALBERTVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 35951 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2568783999 | ||||||||
| FaxNumber: | 2568783779 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/07/2016 | ||||||||
| LastUpdateDate: | 06/20/2018 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 1-116054 | AL | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.