Provider Demographics
NPI:1396371423
Name:KASAL, RYLEE NICOLE (RN)
Entity Type:Individual
Prefix:MRS
First Name:RYLEE
Middle Name:NICOLE
Last Name:KASAL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MISS
Other - First Name:RYLEE
Other - Middle Name:NICOLE
Other - Last Name:KARTCHNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9601 S LIMESTONE CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-2811
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9601 S LIMESTONE CIR
Practice Address - Street 2:
Practice Address - City:SOUTH JORDAN
Practice Address - State:UT
Practice Address - Zip Code:84095-2811
Practice Address - Country:US
Practice Address - Phone:801-694-4666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-20
Last Update Date:2020-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT11585220-3102163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical