Provider Demographics
NPI:1750680930
Name:LOPER, KAYLIN T (LPN)
Entity Type:Individual
Prefix:MS
First Name:KAYLIN
Middle Name:T
Last Name:LOPER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:379 E 232ND ST
Mailing Address - Street 2:
Mailing Address - City:EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44123-1539
Mailing Address - Country:US
Mailing Address - Phone:216-253-5319
Mailing Address - Fax:
Practice Address - Street 1:379 E 232ND ST
Practice Address - Street 2:
Practice Address - City:EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44123-1539
Practice Address - Country:US
Practice Address - Phone:216-253-5319
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-27
Last Update Date:2011-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN. 142358164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse