Individual
JACKIE M KYPTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RNFA
Contact information
Practice address
2050 E CHISHOLM TRL, FLAGSTAFF, AZ 86001-9328
(928) 714-9379
Mailing address
2050 E CHISHOLM TRL, FLAGSTAFF, AZ 86001-9328
(928) 714-9379
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN105443
AZ
Other
Enumeration date
05/11/2011
Last updated
05/11/2011
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