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General NPI Number Information
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NPI Number | 1881217826
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Entity Type | Individual
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Provider Name | KYLIE FIELD HADUCK ATC
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Gender | Female
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 03/10/2025
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Provider Practice Location Address
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Address Line | 810 MITCHELL AVE
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City | SALISBURY
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State | NC
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Zip | 28144-6253
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Country | US
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Telephone | 704-216-5633
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Fax | 704-639-0785
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Provider Business Mailing Address
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Address Line | PO BOX 60447
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City | CHARLOTTE
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State | NC
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Zip | 28260-0447
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Country | US
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Telephone |
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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 | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | LAT-4170
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-15093
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License Number State | NC
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