Provider Demographics
NPI:1225845514
Name:HOWE, KYLIE
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:HOWE
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 1:304 RIDGEVIEW ST
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-1523
Mailing Address - Country:US
Mailing Address - Phone:217-597-3992
Mailing Address - Fax:
Practice Address - Street 1:304 RIDGEVIEW ST
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-1523
Practice Address - Country:US
Practice Address - Phone:217-597-3992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL043135581164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse