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General NPI Number Information
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NPI Number | 1770303083
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Entity Type | Individual
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Provider Name | KYLEI LYNA DULES NP
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Gender | Female
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Dates
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Enumeration Date | 10/11/2024
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 104 S LAKEVIEW AVE
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City | STURGIS
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State | MI
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Zip | 49091-1947
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Country | US
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Telephone | 269-319-8850
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Fax | 269-464-0101
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Provider Business Mailing Address
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Address Line | 549 GILEAD LAKE RD
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City | BRONSON
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State | MI
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Zip | 49028-9205
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Country | US
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Telephone | 517-227-1909
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 4704334773
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License Number State | MI
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