Individual
DR. JOHN KEITH NYLUND
Active
Individual
DR. JOHN KEITH NYLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
CO34111
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CO34111
STATE MEDICAL LISCECE
CA
01
—
W9243
PPTAN #
CA
01
—
WWH7CB
PASSWORD FOR PALMETTO
CA
Enumeration date
04/03/2008
Last updated
09/25/2008
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