Provider Demographics
NPI:1184211468
Name:KDB DELEGATIONS LLC
Entity Type:Organization
Organization Name:KDB DELEGATIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:D
Authorized Official - Last Name:HARDIN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:509-301-2602
Mailing Address - Street 1:1503 HOBSON ST
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-2427
Mailing Address - Country:US
Mailing Address - Phone:509-301-2602
Mailing Address - Fax:844-975-1187
Practice Address - Street 1:1503 HOBSON ST
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-2427
Practice Address - Country:US
Practice Address - Phone:509-301-2602
Practice Address - Fax:844-975-1187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-21
Last Update Date:2020-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty