Healthcare Provider Details

I. General information

NPI: 1225294770
Provider Name (Legal Business Name): RICHARD DAVID KUYLEN NP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2008
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 W CAUSEWAY APPROACH STE B
MANDEVILLE LA
70471-3022
US

IV. Provider business mailing address

1117 S TYLER ST
COVINGTON LA
70433-2327
US

V. Phone/Fax

Practice location:
  • Phone: 858-923-3609
  • Fax:
Mailing address:
  • Phone: 985-892-3360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberRN056659 AP05551
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberRN056659 AP05551
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: