Provider Demographics
NPI:1861086316
Name:KINLEY, KYLE
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:KINLEY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 DRY TOP RD
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-4803
Mailing Address - Country:US
Mailing Address - Phone:814-810-7433
Mailing Address - Fax:
Practice Address - Street 1:113 DRY TOP RD
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-4803
Practice Address - Country:US
Practice Address - Phone:814-810-7433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-25
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator