Provider Demographics
NPI:1952924466
Name:KINDLE, VICTORIA (CNA, HHA)
Entity type:Individual
Prefix:MRS
First Name:VICTORIA
Middle Name:
Last Name:KINDLE
Suffix:
Gender:F
Credentials:CNA, HHA
Other - Prefix:MISS
Other - First Name:VICTORIA
Other - Middle Name:
Other - Last Name:FAJARDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNA, HHA
Mailing Address - Street 1:4989 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072-9548
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4989 N 3RD ST
Practice Address - Street 2:
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072-9548
Practice Address - Country:US
Practice Address - Phone:307-745-8997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-19
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY374U00000X
376J00000X, 385H00000X, 172V00000X
WY26963376K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker
No376K00000XNursing Service Related ProvidersNurse's Aide
No385H00000XRespite Care FacilityRespite Care