Healthcare Provider Details

I. General information

NPI: 1639091150
Provider Name (Legal Business Name): KYRA METILINOS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 S MAIN ST
ANDOVER MA
01810-4136
US

IV. Provider business mailing address

22 HOPKINS ST
DRACUT MA
01826-3412
US

V. Phone/Fax

Practice location:
  • Phone: 978-551-6197
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number10028999
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: