Healthcare Provider Details

I. General information

NPI: 1265799159
Provider Name (Legal Business Name): KALEE GOLDEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2012
Last Update Date: 10/03/2024
Certification Date: 10/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1188 SKYLAND DR
SYLVA NC
28779-8002
US

IV. Provider business mailing address

1188 SKYLAND DR
SYLVA NC
28779-8002
US

V. Phone/Fax

Practice location:
  • Phone: 828-339-2273
  • Fax: 828-339-2274
Mailing address:
  • Phone: 828-339-2273
  • Fax: 828-339-2274

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number246924
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5019849
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: