Provider Demographics
NPI:1194251215
Name:KYLE, KALINA MARIE (RN)
Entity type:Individual
Prefix:
First Name:KALINA
Middle Name:MARIE
Last Name:KYLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KALINA
Other - Middle Name:MARIE
Other - Last Name:EDDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:3020 S DELAWARE ST
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80110-1438
Mailing Address - Country:US
Mailing Address - Phone:303-564-9516
Mailing Address - Fax:
Practice Address - Street 1:3020 S DELAWARE ST
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80110-1438
Practice Address - Country:US
Practice Address - Phone:303-564-9516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-10
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.0195412163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse