KAYLIE ELIZABETH WREN (NPI# 1396117180) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396117180 |
| Entity Type | Individual |
| Full Name | KAYLIE ELIZABETH WREN |
| Credential | P.A. |
| Practice Address |
940 General Booth Blvd Virginia Beach VA 23451-4861 |
| Mailing Address |
1033 28th St Newport News VA 23607-4233 |
| Practice Telephone | 7574253610 |
| Mailing Telephone | 7579522160 |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2016-11-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 0110005110 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
940 GENERAL BOOTH BLVD |
| City | VIRGINIA BEACH |
| State | VA |
| Zip Code | 23451-4861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306814173 | Pauline Carvella Reed | Family Medicine | 940 General Booth Blvd, Suite A, Virginia Beach, VA 23451-4857 | 2006-03-09 |
| 1104374693 | Sara Deatherage | Registered Nurse | 940 General Booth Blvd, Virginia Beach, VA 23451-4861 | 2016-09-14 |
| 1417385931 | Holley Family Dentistry of Virginia Beach | Dentist | 940 General Booth Blvd, Suite C, Virginia Beach, VA 23451 | 2013-10-18 |
| 1851723894 | Tiffany M Griffin | Physician Assistant | 940 General Booth Blvd, Suite A, Virginia Beach, VA 23451-4861 | 2013-08-01 |
| 1053545681 | Lauren Nicole Gillis | Nurse Practitioner | 940 General Booth Blvd, Virginia Beach, VA 23451-4857 | 2009-05-11 |
| 1902050875 | Peninsula Institute for Community Health Inc | Clinic/Center | 940 General Booth Blvd, Suite A, Virginia Beach, VA 23451-4857 | 2008-11-05 |
| 1598808883 | Carter L Richards | Dentist | 940 General Booth Blvd, Suite #c, Virginia Beach, VA 23451-4857 | 2007-02-15 |
| 1922117142 | Andrei San-marina | Internal Medicine | 940 General Booth Blvd, Virginia Beach, VA 23451-4861 | 2006-08-30 |
| 1982633640 | Donald L Cochran | Family Medicine | 940 General Booth Blvd, Virginia Beach, VA 23451-4861 | 2006-07-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316547268 | Brynn Arica Carey | Speech-Language Pathologist | Laskin Road Annex, 1413 Laskin Road, Virginia Beach, VA 23451 | 2020-10-29 |
| 1851864094 | Erica Genevieve Johns | Counselor | 253 C Street, Camp Pendleton, Virginia Beach, VA 23451 | 2019-01-10 |
| 1407327729 | Crystal Michelle Larios | Physical Therapy Assistant | Westminster Canterbury, Virginia Beach, VA 23451 | 2018-12-14 |
| 1215423322 | Ketan Patel | Dentist | 395 Norfolk Ave, Virginia Beach, VA 23451 | 2018-07-02 |
| 1356844427 | Kristina Maria Matthews | Nurse's Aide | 1206 Laskin Road, Suite 140-g, Virginia Beach, VA 23451 | 2018-03-14 |
| 1437652823 | Beach Medical Suppliers LLC | Durable Medical Equipment & Medical Supplies | 2256 W. Great Neck Rd, Virginia Beach, VA 23451 | 2018-03-13 |
| 1740782291 | Sherree Weeks | Speech-Language Pathologist | 1413 Laskin Rd., Va. Beach, VA 23451 | 2018-03-01 |
| 1649709007 | Christine Herslow | Registered Nurse | 2200 Elder Road, Virginia Beach, VA 23451 | 2017-06-08 |
| 1538611066 | Wal-mart Stores East, Lp | Technician/Technologist | 546 First Colonial Road, Virginia Beach, VA 23451 | 2016-11-01 |
| 1306182795 | John Leroy Stacy Jr. | Counselor | 409 Birdneck Cir, Virginia Beach, VA 23451 | 2012-12-12 |
| Find all providers in zip 23451 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047348 | Sara Minor Khadivi | Physician Assistant | 249 Cassady Ave, Virginia Beach, VA 23452-4248 | 2020-03-07 |
| 1659913283 | Jacqueline Alexander Oliver | Physician Assistant | 3198 Pacific Ave Ste 104, Virginia Beach, VA 23451-2949 | 2019-10-15 |
| 1831650266 | Amelia Jo Crutsinger | Physician Assistant | 1644 Kepler Bnd, Virginia Beach, VA 23454 | 2019-03-28 |
| 1972067908 | Taylor Elizabeth Rose | Physician Assistant | 445 Caren Dr, Virginia Beach, VA 23452-3511 | 2019-01-23 |
| 1427521533 | Stephanie Michelle Smith | Physician Assistant | 2025 Williams Farm Rd, Virginia Beach, VA 23457-1390 | 2019-01-10 |
| 1902374044 | Patricia Lynette Nash | Physician Assistant | 5589 Greenwich Rd Ste 175, Virginia Beach, VA 23462-6564 | 2018-11-07 |
| 1851884332 | Aaron Zadai | Physician Assistant | 4437 Blackwater Rd, Virginia Beach, VA 23457-1124 | 2018-06-11 |
| 1629561329 | Mary Katherine Pratt | Physician Assistant | 828 Healthy Way Ste 350, Virginia Beach, VA 23462 | 2018-06-07 |
| 1093196024 | Stephanie Zeiber | Physician Assistant | 3325 Woodsman Ln, Virginia Beach, VA 23452-5226 | 2015-06-16 |
| 1255733051 | Megan Christine Mcdevitt | Physician Assistant | 1168 First Colonial Rd Ste A, Virginia Beach, VA 23454 | 2014-09-23 |
| Find all providers in VIRGINIA BEACH | ||||
| City | VIRGINIA BEACH |
| Zip Code | 23451 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.