Kayla M Wallette, AAS
Individual provider Active NPI Other Technician · Rolla, ND
NPI 1053946343 · NPPES record last updated Mar 6, 2020
Key facts
- NPI
- 1053946343
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Other Technician 247200000X
- Practice address
- 1102 Main Ave
Rolla, ND 58367 - Phone
- (701) 477-9050
- NPI assigned
- Mar 6, 2020
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Associate of Applied Science
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Other Technician | 247200000X | Yes |
Addresses
Primary practice location
1102 Main Ave
Rolla, ND 58367
Mailing address
200 Highway 2 W
Devils Lake, ND 58301-3532
Phone (701) 665-2200
Other providers in Rolla, ND
- Tri-Care Home Health Inc
- Turner Dental Office PC
- William Warren Turner
- Turtle Mountain Home Healthcare LLC
- Michael Vandal
- Regina Wallette
- Luke Weston
- Jodi M Wilkie
- Frances Wolhart
All providers in Rolla, ND · Other Technician in North Dakota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 6, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.