Provider Demographics
NPI:1063984367
Name:JAMES, KYLEE NOEL
Entity type:Individual
Prefix:MS
First Name:KYLEE
Middle Name:NOEL
Last Name:JAMES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 GARDEN PL
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:OH
Mailing Address - Zip Code:43302-5862
Mailing Address - Country:US
Mailing Address - Phone:740-361-1885
Mailing Address - Fax:
Practice Address - Street 1:570 GARDEN PL
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-5862
Practice Address - Country:US
Practice Address - Phone:740-361-1885
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-27
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
0OtherNO INSURANCE