Provider Demographics
NPI:1750954129
Name:SHEETS, KYLIN NICOLE (ATC)
Entity type:Individual
Prefix:
First Name:KYLIN
Middle Name:NICOLE
Last Name:SHEETS
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 E 3RD ST APT 2B
Mailing Address - Street 2:
Mailing Address - City:HISTORIC NEW CASTLE
Mailing Address - State:DE
Mailing Address - Zip Code:19720-4550
Mailing Address - Country:US
Mailing Address - Phone:304-281-7914
Mailing Address - Fax:
Practice Address - Street 1:100 VALLEY CENTER RD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-2950
Practice Address - Country:US
Practice Address - Phone:302-994-1200
Practice Address - Fax:302-994-1233
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2021-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ3-00007952255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer