Provider Demographics
NPI:1326323866
Name:STAPLES, KAYLON NJOLI EURA
Entity Type:Individual
Prefix:MS
First Name:KAYLON
Middle Name:NJOLI EURA
Last Name:STAPLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3540 W SAHARA AVE # 125
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89102-5816
Mailing Address - Country:US
Mailing Address - Phone:702-336-9155
Mailing Address - Fax:
Practice Address - Street 1:2755 W CHEYENNE AVE STE 109
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89032-3831
Practice Address - Country:US
Practice Address - Phone:702-868-6365
Practice Address - Fax:702-868-6366
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-16
Last Update Date:2011-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner