Healthcare Provider Details
I. General information
NPI: 1316557119
Provider Name (Legal Business Name): JULIA KYLE
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/06/2020
Last Update Date: 07/09/2021
Certification Date: 07/09/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
501 WILSON LN STE 3
ELKINS WV
26241-5216
US
IV. Provider business mailing address
501 WILSON LN STE 3
ELKINS WV
26241-5216
US
V. Phone/Fax
- Phone: 304-636-9396
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: