Healthcare Provider Details

I. General information

NPI: 1831868967
Provider Name (Legal Business Name): KALYNNE RENEE BOYLES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2021
Last Update Date: 02/10/2025
Certification Date: 02/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11612 BOLTHOUSE DR STE 110
BAKERSFIELD CA
93311-8497
US

IV. Provider business mailing address

PO BOX 1139
BAKERSFIELD CA
93302-1139
US

V. Phone/Fax

Practice location:
  • Phone: 661-654-8338
  • Fax: 661-654-8383
Mailing address:
  • Phone: 661-371-2796
  • Fax: 661-438-1746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95018272
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: