Provider Demographics
NPI:1073280202
Name:SWEENEY, KYLA (PA-C)
Entity Type:Individual
Prefix:
First Name:KYLA
Middle Name:
Last Name:SWEENEY
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6630 S MCCARRAN BLVD STE B18
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-6136
Mailing Address - Country:US
Mailing Address - Phone:775-237-2833
Mailing Address - Fax:775-237-2823
Practice Address - Street 1:6630 S MCCARRAN BLVD STE B18
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-6136
Practice Address - Country:US
Practice Address - Phone:775-237-2833
Practice Address - Fax:775-237-2823
Is Sole Proprietor?:No
Enumeration Date:2021-08-25
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVPA0622363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant