Basic Information
| Provider Information | |||||||||
| NPI: | 1457812604 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | WAPLE | ||||||||
| FirstName: | KAYLA | ||||||||
| MiddleName: | ANNE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6053 MULBERRY DR | ||||||||
| Address2: | |||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483141460 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5868797189 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 13213 E 14 MILE RD | ||||||||
| Address2: | |||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483126302 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5869394374 | ||||||||
| FaxNumber: | 5869394783 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2019 | ||||||||
| LastUpdateDate: | 03/29/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 106S00000X | Y |
No ID Information.