Provider Demographics
NPI:1801522800
Name:KYLE, JUDITH DIANE (RN)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:DIANE
Last Name:KYLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
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Mailing Address - Street 1:1006 NORTHWEST BLVD
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-1533
Mailing Address - Country:US
Mailing Address - Phone:580-220-6764
Mailing Address - Fax:580-220-6383
Practice Address - Street 1:1006 NORTHWEST BLVD
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-1533
Practice Address - Country:US
Practice Address - Phone:580-220-6764
Practice Address - Fax:580-220-6383
Is Sole Proprietor?:No
Enumeration Date:2022-08-01
Last Update Date:2022-08-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OKR0053771163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator