1235721259 NPI number — KAYLA BROOKE SPEIGHTS APRN

Table of content: KAYLA BROOKE SPEIGHTS APRN (NPI 1235721259)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235721259 NPI number — KAYLA BROOKE SPEIGHTS APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPEIGHTS
Provider First Name:
KAYLA
Provider Middle Name:
BROOKE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SUTTON
Provider Other First Name:
KAYLA
Provider Other Middle Name:
BROOKE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1235721259
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/07/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1060
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARSHALL
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72650-1060
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
870-448-5733
Provider Business Mailing Address Fax Number:
877-460-4576

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11720 SR 27
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HECTOR
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-284-2213
Provider Business Practice Location Address Fax Number:
877-460-4576
Provider Enumeration Date:
02/10/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LF0000X , with the licence number:  125581 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 262996758 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".




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