Provider Demographics
NPI:1629964028
Name:DOERING, KYLA MARIE
Entity type:Individual
Prefix:
First Name:KYLA
Middle Name:MARIE
Last Name:DOERING
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2915 HOEFER AVE
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57701-7266
Mailing Address - Country:US
Mailing Address - Phone:605-939-1718
Mailing Address - Fax:
Practice Address - Street 1:2915 HOEFER AVE
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57701-7266
Practice Address - Country:US
Practice Address - Phone:605-939-1718
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR060470163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse