Individual
KAYLEE RAGAN KWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
1359 OLD WATER WORKS RD SW, FORT PAYNE, AL 35968-3347
(256) 997-5900
Mailing address
1359 OLD WATER WORKS RD SW, FORT PAYNE, AL 35968-3347
(256) 997-5900
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1-183547
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-183547
AL REGISTERED NURSE LICENSE
AL
Enumeration date
10/28/2020
Last updated
10/28/2020
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