Provider Demographics
NPI:1467080382
Name:FOLK, KYLE RICHARD (PHARMD)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:RICHARD
Last Name:FOLK
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 SHADOW LN STE 110
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89106-4132
Mailing Address - Country:US
Mailing Address - Phone:877-480-1755
Mailing Address - Fax:877-480-1752
Practice Address - Street 1:701 SHADOW LN STE 110
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4132
Practice Address - Country:US
Practice Address - Phone:877-480-1755
Practice Address - Fax:877-480-1752
Is Sole Proprietor?:No
Enumeration Date:2020-03-27
Last Update Date:2020-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV18571183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist