Provider Demographics
NPI:1689475337
Name:RINGO, KAYLA
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:RINGO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6183 WINDMILL LN
Mailing Address - Street 2:
Mailing Address - City:GRANT PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60940-4420
Mailing Address - Country:US
Mailing Address - Phone:815-953-8656
Mailing Address - Fax:
Practice Address - Street 1:200 PORTLAND ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-6525
Practice Address - Country:US
Practice Address - Phone:573-886-6992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-20
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program