Provider Demographics
NPI:1659137164
Name:PASTRICK, KYLEE LYNN (RN)
Entity Type:Individual
Prefix:
First Name:KYLEE
Middle Name:LYNN
Last Name:PASTRICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:KYLEE
Other - Middle Name:LYNN
Other - Last Name:WOLFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:125 JOHNETTA RD
Mailing Address - Street 2:
Mailing Address - City:VANDERGRIFT
Mailing Address - State:PA
Mailing Address - Zip Code:15690-8216
Mailing Address - Country:US
Mailing Address - Phone:724-714-4940
Mailing Address - Fax:
Practice Address - Street 1:1010 DELAFIELD RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15215-1802
Practice Address - Country:US
Practice Address - Phone:800-698-2411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN621479163WR0400X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation