Provider Demographics
NPI:1285057083
Name:EPLER, KYLE (LPN)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:EPLER
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4528 N 550 E
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:IN
Mailing Address - Zip Code:47371-7956
Mailing Address - Country:US
Mailing Address - Phone:260-301-6508
Mailing Address - Fax:260-589-6521
Practice Address - Street 1:4528 N 550 E
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:IN
Practice Address - Zip Code:47371-7956
Practice Address - Country:US
Practice Address - Phone:260-301-6508
Practice Address - Fax:260-589-6521
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2014-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27069176A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN27069176AOtherINDIANA STATE BOARD OF NURSING