Provider Demographics
NPI:1073256731
Name:KYLE, BRITTANY MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:MARIE
Last Name:KYLE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:MARIE
Other - Last Name:KYLE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 2691
Mailing Address - Street 2:
Mailing Address - City:ESTACADA
Mailing Address - State:OR
Mailing Address - Zip Code:97023-2691
Mailing Address - Country:US
Mailing Address - Phone:503-705-7216
Mailing Address - Fax:
Practice Address - Street 1:25324 S HIGHWAY 211
Practice Address - Street 2:
Practice Address - City:ESTACADA
Practice Address - State:OR
Practice Address - Zip Code:97023-9677
Practice Address - Country:US
Practice Address - Phone:503-705-7216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR202203900LPN164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse