Individual
KYLE J FECTEAU
Active
Individual
KYLE J FECTEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN192626
AZ
163WC0200X
Critical Care Medicine Registered Nurse
12743151
AZ
363LA2100X
Acute Care Nurse Practitioner
Primary
269868
AZ
Other
Enumeration date
11/08/2021
Last updated
02/03/2022
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