Provider Demographics
NPI:1831997774
Name:GREENE, KAYLA LYNETTE
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:LYNETTE
Last Name:GREENE
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 1:11 LILAC CT
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60490-2018
Mailing Address - Country:US
Mailing Address - Phone:630-465-5705
Mailing Address - Fax:
Practice Address - Street 1:11 LILAC CT
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60490-2018
Practice Address - Country:US
Practice Address - Phone:630-465-5705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-06
Last Update Date:2025-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula