Provider Demographics
NPI:1548749997
Name:MALNAR, KAYLA (CST)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:MALNAR
Suffix:
Gender:F
Credentials:CST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10561 JEFFREYS ST STE 230
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4268
Mailing Address - Country:US
Mailing Address - Phone:702-565-6565
Mailing Address - Fax:702-565-8898
Practice Address - Street 1:10561 JEFFREYS ST STE 230
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4268
Practice Address - Country:US
Practice Address - Phone:702-565-6565
Practice Address - Fax:702-565-8898
Is Sole Proprietor?:No
Enumeration Date:2018-08-07
Last Update Date:2018-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV180736246ZS0410X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV180736OtherNATIONAL BOARD OF SURGICAL TECHNOLOGY