Provider Demographics
NPI:1598445678
Name:KLINE, KHYLA MARIE (PMHNP)
Entity Type:Individual
Prefix:
First Name:KHYLA
Middle Name:MARIE
Last Name:KLINE
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:427 2ND ST
Mailing Address - Street 2:
Mailing Address - City:WEST POINT
Mailing Address - State:IA
Mailing Address - Zip Code:52656-9442
Mailing Address - Country:US
Mailing Address - Phone:319-371-0914
Mailing Address - Fax:
Practice Address - Street 1:1225 S GEAR AVE STE 251
Practice Address - Street 2:
Practice Address - City:WEST BURLINGTON
Practice Address - State:IA
Practice Address - Zip Code:52655-1688
Practice Address - Country:US
Practice Address - Phone:319-768-3700
Practice Address - Fax:319-768-3712
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAG176855363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health