Provider Demographics
NPI:1619858479
Name:HADEN, KYLE (ATC)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:HADEN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7627 E 37TH ST N APT 2403
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2807
Mailing Address - Country:US
Mailing Address - Phone:785-614-4410
Mailing Address - Fax:
Practice Address - Street 1:7627 E 37TH ST N APT 2403
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226-2807
Practice Address - Country:US
Practice Address - Phone:785-614-4410
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer