Individual
KYLE NATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PAC1114
ND
363AM0700X
Medical Physician Assistant
Primary
PAC1114
ND
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/15/2023
Last updated
09/24/2025
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