Provider Demographics
NPI:1851907455
Name:D'HOOSTELAERE, KYLIE (RN, IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:KYLIE
Middle Name:
Last Name:D'HOOSTELAERE
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3202 NW ALBERTA ST
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-8430
Mailing Address - Country:US
Mailing Address - Phone:864-884-6168
Mailing Address - Fax:
Practice Address - Street 1:3202 NW ALBERTA ST
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-8430
Practice Address - Country:US
Practice Address - Phone:864-884-6168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-18
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR12285163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation ConsultantGroup - Single Specialty