Provider Demographics
NPI:1235471988
Name:MCDONALD, KAYLE LYNN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:KAYLE
Middle Name:LYNN
Last Name:MCDONALD
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15798 N MCCARTNEY ST
Mailing Address - Street 2:
Mailing Address - City:RATHDRUM
Mailing Address - State:ID
Mailing Address - Zip Code:83858-5070
Mailing Address - Country:US
Mailing Address - Phone:760-995-7759
Mailing Address - Fax:
Practice Address - Street 1:15798 N MCCARTNEY ST
Practice Address - Street 2:
Practice Address - City:RATHDRUM
Practice Address - State:ID
Practice Address - Zip Code:83858-5070
Practice Address - Country:US
Practice Address - Phone:760-995-7759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID74488363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily