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NPI Code Detail

MEDICARE: IRIS KYNARD FNP

MEDICARE: IRIS KYNARD FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1-115266AL

General Provider Information

NPI Number : 1629763727
Entity Type Code : Individual
Provider Name (Legal Business Name) : IRIS KYNARD FNP
Provider Business Mailing Address
First Line : PO BOX 7410723
Second Line :
City : CHICAGO
State : IL
Zip : 60674-0723
Country : US
Telephone Number : 609-585-1122
Fax Number : 702-977-1496
Provider Business Practice Location Address
First Line : 400 UNIVERSITY PARK DR
Second Line :
City : BIRMINGHAM
State : AL
Zip : 35209-6784
Country : US
Telephone Number : 205-870-0786
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2023
Last Update Date : 06/22/2026

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