Provider Demographics
NPI: | 1407999774 |
---|---|
Name: | KITE, GAYLE (ARNP) |
Entity type: | Individual |
Prefix: | |
First Name: | GAYLE |
Middle Name: | |
Last Name: | KITE |
Suffix: | |
Gender: | F |
Credentials: | ARNP |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 2151 45TH ST |
Mailing Address - Street 2: | SUITE 207 |
Mailing Address - City: | WEST PALM BEACH |
Mailing Address - State: | FL |
Mailing Address - Zip Code: | 33407-2026 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 561-842-9550 |
Mailing Address - Fax: | 561-842-9114 |
Practice Address - Street 1: | 2151 45TH ST |
Practice Address - Street 2: | SUITE 207 |
Practice Address - City: | WEST PALM BEACH |
Practice Address - State: | FL |
Practice Address - Zip Code: | 33407-2026 |
Practice Address - Country: | US |
Practice Address - Phone: | 561-842-9550 |
Practice Address - Fax: | 561-842-9114 |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2007-02-15 |
Last Update Date: | 2007-11-28 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
FL | ARNP2141282 | 363LP0808X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 363LP0808X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psychiatric/Mental Health |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
FL | Q04015 | Medicare UPIN | |
FL | K4871 | Medicare ID - Type Unspecified | GROUP MEDICARE # |
FL | U18652 | Medicare ID - Type Unspecified |