Provider Demographics
NPI:1639711427
Name:BARKER, KYLE KATHLEEN LORING (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:KYLE
Middle Name:KATHLEEN LORING
Last Name:BARKER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 DIANA DR APT 202
Mailing Address - Street 2:
Mailing Address - City:HALLANDALE BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33009-4850
Mailing Address - Country:US
Mailing Address - Phone:760-486-3063
Mailing Address - Fax:
Practice Address - Street 1:1601 N PALM AVE STE 101
Practice Address - Street 2:
Practice Address - City:PEMBROKE PINES
Practice Address - State:FL
Practice Address - Zip Code:33026-3240
Practice Address - Country:US
Practice Address - Phone:954-438-0033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-13
Last Update Date:2019-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11003624363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily