Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | MD126191 | OR |
N | 207V00000X | Obstetrician & Gynecologist | ME89990 | FL |
NPI | 1003859372 |
---|---|
Provider Name | Dr. Brooke H. L. Kyle |
First Address | Springfield, OR 97475-0120 |
Second Address | Springfield, OR 97477-7514 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 06/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500610616 | (05) | OR |