Provider Demographics
NPI:1235599564
Name:KYLES, RHEA EVETTE (FNP)
Entity Type:Individual
Prefix:
First Name:RHEA
Middle Name:EVETTE
Last Name:KYLES
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 1:6639 SULLIVAN RD
Mailing Address - Street 2:
Mailing Address - City:GREENWELL SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70739-3112
Mailing Address - Country:US
Mailing Address - Phone:225-261-6314
Mailing Address - Fax:225-261-7546
Practice Address - Street 1:2255 S BURNSIDE AVE
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:LA
Practice Address - Zip Code:70737-4642
Practice Address - Country:US
Practice Address - Phone:225-644-9446
Practice Address - Fax:800-256-3947
Is Sole Proprietor?:No
Enumeration Date:2016-02-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08714363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA2413791Medicaid