Provider Demographics
NPI:1285252403
Name:KALNYSH, MARIYA (FNP)
Entity type:Individual
Prefix:
First Name:MARIYA
Middle Name:
Last Name:KALNYSH
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 ROYAL PALM WAY PH 302
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33432-8738
Mailing Address - Country:US
Mailing Address - Phone:954-531-3880
Mailing Address - Fax:
Practice Address - Street 1:1 ROYAL PALM WAY PH 302
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33432-8738
Practice Address - Country:US
Practice Address - Phone:954-531-3880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9416490163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse