Healthcare Provider Details

I. General information

NPI: 1245301886
Provider Name (Legal Business Name): KARIN SANDRA NYLUND M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/13/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

428 BILTMORE AVE
ASHEVILLE NC
28801-4502
US

IV. Provider business mailing address

1369 PAGE ST APT B
SAN FRANCISCO CA
94117-3027
US

V. Phone/Fax

Practice location:
  • Phone: 828-213-4502
  • Fax:
Mailing address:
  • Phone: 415-621-5878
  • Fax: 415-750-4845

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number2017-02603
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberA79247
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number2017-02603
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: