Provider Demographics
NPI:1942893573
Name:KAHLER, PAYTON NICOLE (LPN)
Entity Type:Individual
Prefix:
First Name:PAYTON
Middle Name:NICOLE
Last Name:KAHLER
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 1:387 11TH ST S OFC 2
Mailing Address - Street 2:
Mailing Address - City:WAHPETON
Mailing Address - State:ND
Mailing Address - Zip Code:58075-4677
Mailing Address - Country:US
Mailing Address - Phone:701-642-2336
Mailing Address - Fax:701-671-9017
Practice Address - Street 1:387 11TH ST S OFC 2
Practice Address - Street 2:
Practice Address - City:WAHPETON
Practice Address - State:ND
Practice Address - Zip Code:58075-4677
Practice Address - Country:US
Practice Address - Phone:701-642-2336
Practice Address - Fax:701-671-9017
Is Sole Proprietor?:No
Enumeration Date:2021-02-15
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDL17079164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse