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Kyle Tyler Jenkins

Student in an Organized Health Care Education/Training Program in Danville, PA. Individual provider (NPI-1).

NPI number1164096251
StatusActive
Last updated in NPPESMay 13, 2021

Details

NPI
1164096251
Entity type
Individual (NPI-1)
Name
Kyle Tyler Jenkins
Sex
Male
Sole proprietor
No
Enumeration date
May 13, 2021
Certification date
May 13, 2021
Last updated
May 13, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

100 N Academy Ave
Danville, PA 17822-9800

Phone 570-271-6775 · Fax 570-271-6762

Mailing address

100 N Academy Ave
Danville, PA 17822-9800

Phone 570-271-6775 · Fax 570-271-6762

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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

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