Individual
KYLE DAVID JASPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PMHNP, MSN, RN
Contact information
Practice address
11801 GO FOR BROKE RD, ROSEVILLE, CA 95678-7055
(916) 409-8261
Mailing address
11801 GO FOR BROKE RD, ROSEVILLE, CA 95678-7055
(562) 895-7814
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95015599
CA
Other
Enumeration date
08/04/2019
Last updated
08/24/2023
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